PROGRAM POLICY MANUAL

Master of Science in Physician Assistant Studies

Class of 2015

1

TABLE OF CONTENTS

PART I: GENERAL POLICIES AND PROCEDURES

Introduction

Program Accreditation 6

Program Sponsorship and Philosophy 7

Goals of the Physician Assistant Program 9

Department Faculty and Staff 10

Advisement 14

Program Essential Functions 15

Professionalism 17

Curriculum and Academic Policies 22

Academic Performance Standards 24

Academic Integrity 34

Academic Services

Academic Tutoring 38

Career Center 39

Computer Labs 39

Disability Services 40

Financial Aid 40

University Library 41

Student Health

Student Health Services 41

Mental Health and Counseling 42

Health Insurance 42

Health and Immunization Documentation 42

Injuries & Needlestick/Exposure Protocol 44

Absence, Leave and Withdrawal

Absence 46

Absence from Examination 47

Absence from Clinical Rotation 47

Bereavement 47

Leave of Absence 48

Suspension 48

Withdrawal 48

Procedure for Readmission 48

Communication

Cellular Phones 48

Emails 48

Emergency Phone Calls 49

Student Representation 49

Director’s Hour 49

Miscellaneous Policies

Employment During the Program 49

Examination Security 49

Holidays 49

Weather-Related Emergencies 50

2 PART II: POLICIES, PROCEDURES & OBJECTIVES RELATED TO CLINICAL

ROTATIONS

Clinical Rotations and Affiliation Agreements

Core Rotations 51

Elective Rotations 53

Student-Initiated Rotations 53

Medical Missions 53

Rotation Specific Policies

Assignments 53

Charting 54

Confidentiality 54

Holidays 54

Identification 54

Interviews 54

Patient Safety 54

Rotation Schedule 55

Student Scope of Practice 55

Site Specific Policies 56

Travel to Clinical Sites 56

Site Visits 56

Academic Requirements for Clinical Courses

E*Value 57

Clinical Logs 57

Written Assignments 57

Mid-Rotation Evaluations 58

End of Rotation Preceptor Evaluation 59

Post-Rotation Examinations 59

Student Evaluation of Clinical Site 59

Seminar 60

Oral Presentations 63

Clinical Evaluation

Rotation Grading 64

Remediation Procedures 64

Rotation Goals and Objectives

General Goals and Objectives 66

Goals and Objectives for Specific Rotations 69

Ambulatory Medicine 70

Internal Medicine 75

Pediatrics 80

Psychiatry 85

Surgery 88

Obstetrics and Gynecology 94

Emergency Medicine 99

Research 105

3 PART III: PREPARING FOR GRADUATION AND THE PANCE

Formative Evaluation 108

Summative Evaluation 109

MSPAS Program Graduation Competencies 110

Preparing for the PANCE 114

PART IV: ADDITIONAL RESOURCES

Accreditation Review Commission on Education of the PA 116

American Academy of Physician Assistants 116

National Commission on Certification of Physician Assistants 117

Pennsylvania Society for Physician Assistants 117

PART V: APPENDICES

A. Receipt and Acknowledgement 119

B. Faculty 120

C. Mid-Semester Advisement Sheet (sample) 121

D. Professional Development Assessment Tool 123

E. NCCPA Content Blueprint for PANCE & PANRE 125

F. Student Academic Mentoring Form 132

G CERTIPHI Health Screening Requirements 134

H. Incident Report 136

I. Site Visit Evaluation Form 138

J. Clinical Rotation Written History and Physical Examination Grading Form 140

K. Evaluation of Topic Paper 143

L. Mid-Rotation Evaluation 145

M. End of Rotation Evaluation 147

N. Student Evaluation of Preceptor / Clinical Site 151

O. Oral Presentation Grading Form 153

P. Competencies ( Self Evaluation Tool ) 155

Q. Summative Professionalism Assessment Tool 159

R. Study Plan Contract 161

4 Notice: POLICY MANUAL UPDATES

This Program Policy Manual for the Master of Science in Physician Assistant Studies (MSPAS)

contains policies and procedures unique to the MSPAS program and is first distributed to stu-

dents as they begin the first professional year. Updated versions of this Policy Manual may be

provided during a student’s enrollment in the program, and the most recent Policy Manual will

supersede all previously distributed versions. Where no specific MSPAS program policy exists,

students are to consult the general guidelines of the Misericordia University Student Handbook.

The MSPAS program reserves the right to update this Policy Manual without prior notice. In the

event of an update without prior notice, all matriculated students will be provided with a written

copy of any updated policies. A student’s continuation in the MSPAS program will be contin-

gent upon submission of a signed and dated ‘Receipt and Acknowledgement’ form (see Appen-

dix A) for the most recent update of the Policy Manual.

Version: Fall 2013

5

PART I:

GENERAL POLICIES AND PROCEDURES

Welcome to the Department of Physician Assistant Studies at

Misericordia University!

We are pleased that you have chosen to join us for your education

and we look forward to working with you to help achieve your pro-

fessional goals.

This manual is designed to serve as a supplement to other University

publications such as the Student Handbook and the University’s

Catalog. It will provide you with important information as you work

your way through your studies.

6

INTRODUCTION

The MSPAS Program Policy Manual is designed to give students general information regarding

the MSPAS program. It is an adjunct to the Misericordia University academic catalog and the

Misericordia University Student Handbook. Please keep this manual in a convenient location so

you can refer to it throughout your physician assistant training. This manual provides vital in-

formation about the MSPAS program and the PA profession. As a beginning MSPAS student,

you are entering into the professional world. You will be afforded respect and honor as a PA.

With this respect comes a great deal of responsibility. Most PAs look back at their student expe-

rience as one of the most challenging and rewarding times in their lives. We are confident you

will regard becoming a physician assistant as one of your life’s most significant milestones. Our

faculty and staff are dedicated to your success, and we wish each of you a bright future as a

healthcare provider.

PROGRAM ACCREDITATION

STANDARD A3.02 The program must inform students of program policies and practices.

The Misericordia University Master of Science in Physician Assistant Studies (MSPAS) program

has applied for and been granted provisional accreditation by the Accreditation Review Commis-

sion on Education for the Physician Assistant (ARC-PA).

This handbook is in part based on the 4th

edition Accreditation Standards for Physician Assistant

Education, published in March 2010. The Standards will be referenced throughout the manual,

as they inform and guide the curriculum, policies and procedures adopted by the MSPAS pro-

gram. The Standards constitute the requirements to which an accredited program is held ac-

countable and provide the basis on which the ARC-PA will confer or deny program accredita-

tion. According to the ARC-PA, “these Standards were initially adopted in 1971 and were re-

vised in 1978, 1985, 1990, 1997, 2000, 2005 and 2010.

ARC-PA commissioners include individuals nominated from the collaborating organizations of

the ARC-PA, which include:

American Academy of Family Physicians

American Academy of Pediatrics

American Academy of Physician Assistants

American College of Physicians

American College of Surgeons

American Medical Association

Physician Assistant Education Association

The collaborating organizations cooperate with the ARC-PA to establish, maintain, and promote

appropriate standards of quality for entry level education of PAs and to provide recognition for

educational programs that meet the requirements outlined in the Standards. These Standards are

used for the development, evaluation, and self-analysis of PA programs.

7 Physician assistants are academically and clinically prepared to practice medicine under the di-

rection and responsible supervision of a doctor of medicine or osteopathic medicine. The physi-

cian-PA team relationship is fundamental to the PA profession and enhances the delivery of

high-quality health care. Within the physician-PA relationship, PAs make clinical decisions and

provide a broad range of diagnostic, therapeutic, preventive, and health maintenance services.

The clinical role of PAs includes primary and specialty care in medical and surgical practice set-

tings. PA practice is focused on patient care and may include educational, research, and adminis-

trative activities.

“The role of the Physician Assistant demands intelligence, sound judgment, intellectual hon-

esty, appropriate interpersonal skills, and the capability to react to emergencies in a calm and

reasoned manner. An attitude of respect for self and others, adherence to the concepts of

privilege and confidentiality in communicating with patients, and a commitment to the pa-

tient’s welfare are essential attributes of the graduated PA. The professional curriculum for

PA education includes basic medical, behavioral, and social sciences; introduction to clinical

medicine and patient assessment; supervised clinical practice; and health policy and profes-

sional practice issues.

“The Standards recognize the continuing evolution of the PA profession and practice and en-

dorse experiential competency-based education as a fundamental tenet of PA education.

While acknowledging the interests of the sponsoring institution as it works with the program

to meet the Standards, the Standards reflect a determination that a commonality in the core

professional curriculum of programs remains desirable and necessary to offer curricula of

sufficient depth and breadth to prepare all PA graduates for practice. The Standards allow

programs to remain creative and innovative in program design and the methods of curriculum

delivery and evaluation used to enable students to achieve program goals and student learn-

ing outcomes. Mastery of learning outcomes is key to preparing students for entry into clini-

cal practice.

“The PA profession has evolved over time to one requiring a high level of academic rigor.

Institutions that sponsor PA programs are expected to incorporate this higher level of aca-

demic rigor into their programs and award an appropriate master’s degree. The ARC-PA

acknowledges ongoing changes in the delivery of health care and in the education of health

professionals.”

- Accreditation Standards for Physician Assistant Education, 4th

Edition

PROGRAM SPONSORSHIP AND PHILOSOPHY

Misericordia University accepted the first class of PA students in the MSPAS program in the fall

semester of the 2012-13 academic years.

The mission statement of the MSPAS Program was developed in January 2011 to reflect pro-

gram outcomes, the developing curriculum, and vision of the founding program director and

medical director. As demonstrated below, the program mission statement reflects the underlying

university mission statement.

8 University Mission Statement

Misericordia University is a Catholic, liberal arts-based, co-educational university. It was found-

ed in 1924 and it is sponsored by the Religious Sisters of Mercy. The university offers both un-

dergraduate and graduate programs. In 1978, the Board of Trustees approved a mission state-

ment that describes the nature and purpose of the university (formerly College Misericordia), and

in 1994 it was revised as follows:

Misericordia University, a co-educational Catholic university sponsored by the Institute of the

Sisters of Mercy of the Americas, is committed to providing quality education to its students and

to shaping its educational programs and policies to express the founding Sisters’ values and atti-

tudes of mercy, service, justice, and hospitality. The university welcomes individuals of all

faiths.

The academic development of each student at the undergraduate level is ensured by the universi-

ty’s commitment to provide a learning experience which cultivates higher-order thinking skills

through the integration of liberal arts and professional studies. To emphasize academic excel-

lence and to develop critical thinking, all undergraduate curricula provide a common liberal arts

base, the objectives of which are further developed in the students’ major areas of study. The

students’ educational programs prepare them for productive careers and continued personal and

professional growth.

Graduate programs at Misericordia University emphasize intellectual discourse and focused aca-

demic growth. The cornerstone of each program is instruction and practice in methods of critical

thinking which promote research and enhanced professional expertise.

Program Mission Statement

The proposed mission statement for the program resonates clearly with values and intellectual

goals set out in the mission statement for the university:

The mission of the Misericordia University Physician Assistant program is to provide opportuni-

ties for exceptional students to acquire the highest quality cognitive education and training expe-

rience in an atmosphere of academic excellence. Graduates will achieve their maximum poten-

tial as able, caring, compassionate, competent, idealistic professionals. The program’s educa-

tional environment will promote an ethos of service, responsibility, morals and ethics, a quest for

excellence, and an avid desire for self-directed lifelong learning in a spiritually enriched envi-

ronment, while preparing students to apply evidence-based knowledge.

Program graduates will exhibit honesty, communication skills, talents, dedication, self-discipline,

initiative, resourcefulness, and judgment as collaborating clinical practitioners. Graduates will

be dedicated to their patients and communities, showing respect for the dignity, worth, and rights

of others, while serving with integrity, accountability, and trust as leaders in an evolving profes-

sion, and as advocates and innovators dedicated to augmenting, complementing, and advancing

the quality, accessibility, and transformation of the healthcare system.

9 STANDARD B1.01 The curriculum must be consistent with the mission and goals of the pro-

gram.

The development process, beginning with the genesis of the program, utilized a thoughtful and

iterative process to integrate a proposed master’s degree in physician assistant studies with the

vision and strategic plan of the university. In September 2010, an initial advisory committee

meeting was conducted. At that time, members of the committee provided suggestions about the

vision for the program and Misericordia University. The committee envisioned a program that

had high ideals for academic rigor and cultural competence, and it affirmed that the program

would be built around the ARC-PA fourth edition standards as the foundation.

The language of the mission statement provides an excellent foundation for a program that will

aspire to uniqueness and excellence: “The program’s educational environment will promote an

ethos of service, responsibility, morals and ethics, a quest for excellence, and an avid desire for

self-directed lifelong learning in a spiritually enriched environment, while preparing students to

apply evidence-based knowledge.” Students will become consumers of the research literature

and acquire basic research competency. This learning dynamic will be integrated throughout the

didactic and clinical years.

GOALS OF THE PHYSICIAN ASSISTANT PROGRAM

The following are program goals for graduates of the Master of Science in Physician Assistant

Studies (MSPAS) curriculum:

Goal 1: Develop the ability to perform a complete physical examination and to organize, inte-

grate, interpret, and present clinical data in a clear, concise manner

Goal 2: Support effective and sensitive communication with patients

Goal 3: Develop critical thinking and evaluative skills

Goal 4: Develop effective communication and teamwork skills with healthcare teams

Goal 5: Provide a comprehensive approach to normal human health and development, both phys-

ical and mental

Goal 6: Provide an explanation and demonstration of the skills needed to assess core diseases

encountered in primary care

Goal 7: Integrate diagnostic assessment skills with knowledge of patient presentation, pharma-

cology, and health care subspecialties to synthesize appropriate treatment plans

Goal 8: Promote cross-cultural and socioeconomic sensitivity, confront prejudice, and support

the development of effective medical practice in a diverse society

Goal 9: Promote a commitment to provide effective, accessible, continuous, comprehensive, and

personalized health care

10 Goal 10: Emphasize the fundamental importance of ethical behavior in medical practice

Goal 11: Promote teaching of patients, community, and colleagues

Goal 12: Participate in the generation of new knowledge in medicine, whether through research,

health policy administration, or as distinguished practitioners

Goal 13: Develop cutting edge knowledge of the Physician Assistant profession and participate

as leaders at the local, state, and national level, shaping future policy and legislation to promote

Physician Assistant practice

Goal 14: Apply knowledge of study designs and statistical methods to the appraisal of clinical

studies and other information on diagnostic and therapeutic effectiveness, and integrate evidence

from scientific studies related to their patients’ health problems

Goal 15: Apply knowledge of basic science concepts to facilitate understanding of the medical

sciences

Goal 16: Demonstrate competency in basic clinical procedures performed by a graduate Physi-

cian Assistant

Goal 17: Upon graduation, be prepared to enter the workforce as a gainfully employed Physician

Assistant with excellent job search skills and the knowledge to obtain and maintain licensure in

any state to practice as a Physician Assistant

DEPARTMENT FACULTY & STAFF

STANDARD A1.04 The sponsoring institution must provide the opportunity for continuing pro-

fessional development of the Program Director and principal faculty by supporting the develop-

ment of their clinical, teaching, scholarly and administrative skills.

STANDARD A2.01 All faculty must possess the educational and experiential qualifications to

perform their assigned duties.

STANDARD A2.13 Instructional faculty must be: qualified through academic preparation and/or

experience to teach assigned subjects and knowledgeable in course content and effective in

teaching assigned subjects.

STANDARD A2.14 In addition to the principal faculty, there must be sufficient instructional fac-

ulty to provide students with the necessary attention, instruction and supervised clinical practice

experiences to acquire the knowledge and competence required for entry into the profession.

The faculty and staff of the Department of Physician Assistant Studies (see Appendix B) are ded-

icated professionals who are focused on preparing you to become physician assistants. Both

principal (full-time) and instructional (adjunct) faculty are carefully selected to teach courses

based in their academic preparation and professional experience. Misericordia takes great care in

selecting qualified faculty and investing in their continued education and professional growth.

Thus, faculty members attend and present at local and national workshops and conferences

11 throughout the year. Individual faculty members have national reputations as educators and con-

duct research on a variety of topics. Some faculty members continue to practice clinically. Thus,

when you need to meet with a faculty member about issues related to your education, it is sug-

gested that you make an appointment to meet with the appropriate individual to address your

concerns.

If you cannot reach your MSPAS faculty advisor, or if there is a true emergency, you may con-

tact the Program Director, Dr. Scott Massey and your issue will be promptly addressed.

PROGRAM DIRECTOR

The Program Director, Scott L. Massey, Ph.D., PA-C, is responsible for the overall oversight of

the MSPAS program and participates in financial planning, development and continuous review

and analysis of program operations. Any issues which cannot be resolved to your satisfaction

with a course instructor or your faculty advisor should be brought to the Program Director’s

attention. The Program Director will meet regularly with your class to discuss any concerns.

Dr. Massey completed his Physician Assistant training at Kettering College in 1987, and he

holds an MS in Counseling Psychology from University of Dayton and a PhD in leadership from

Andrew University. Dr. Massey is a 2008 graduate of the Management Development Program at

Harvard University Graduate School of Education. He brings 20 years of Physician Assistant

clinical and educational experience to Misericordia. Prior to assuming his position here as

Program Director of the Master of Science in Physician Assistant Studies and Founding Chair of

the Department of Physician Assistant Studies, he spent five years at the Massachusetts College

of Pharmacy and Health Sciences (MCPHS) as Associate Dean and then Dean of the School of

Physician Assistant Studies at MCPHS’ campuses in Manchester, NH, and Worcester, MA, and

as Assistant Provost of Academic Affairs and Associate Professor of Physician Assistant Studies.

Dr. Massey is co-author of Classroom to Clinic Study System: Personal Professor for Clinical

Rotations and PANCE/PANRE Review, released in December 2010. In addition, on the national

level Dr. Massey has 10 peer-reviewed research articles, five published abstracts, six paper

presentations, three invited workshops, and over 30 podium presentations (see faculty research

website). Dr. Massey was elected to the PAEA Board of Directors to the position of Dir. at large

for a two-year term (2013-2015).

MEDICAL DIRECTOR

The Medical Director, Stanley J. Dudrick, MD, FACS, is responsible for ensuring that classroom

instruction and clinical experiences provide an appropriate level of instruction for students in the

MSPAS program.

Dr. Dudrick, who holds the Robert S. Anderson, MD, Endowed Chair at Misericordia, is recog-

nized throughout the world for his pioneering research in basic investigative development and

subsequent successful clinical application of total parenteral nutrition (TPN), a central venous

feeding technique that has been acknowledged as one of the four most significant accomplish-

ments in the history of modern surgery, together with the discovery and development of asepsis

and antisepsis, antibiotic therapy, and anesthesia. Dr. Dudrick brings to the proposed program a

40-year history in medical education and research, including leading appointments in the Yale

12 School of Medicine, the University of Texas Medical School at Houston, the University of Penn-

sylvania Medical School, and the Pennsylvania Hospital. He retains an appointment as Professor

of Surgery in the Yale University School of Medicine, and he is Director Emeritus of the Pro-

gram in Surgery and Graduate Medical Education, and Chairman Emeritus of the Department of

Surgery, at Saint Mary’s Hospital, in Waterbury, CT. Dr. Dudrick’s list of published works

numbers over 700 and his record of including students in research and publication are well-

known.

Dr. Dudrick completed his medical training at the University Of Pennsylvania School Of Medi-

cine; his internship at the Hospital of the University of Pennsylvania; his residencies at the Hos-

pital of the University of Pennsylvania. Certified by the American Board of Surgery, Dr.

Dudrick served this distinguished organization continuously for 26 years as an Examiner, Direc-

tor of the Board, and a Senior Board Member. He is a Fellow of the American College of Sur-

geons. He is also a Fellow of the American College of Nutrition and serves as a member of their

21st Century Board. He has served on 15 editorial boards, including the Annals of Surgery. He

is a member of more than 100 academic, honorary, professional, and scientific societies, and he

has been awarded more than 100 other honors, including the American College of Surgeons Ja-

cobson Innovation Award; and the American Surgical Association Medallion for Scientific

Achievement for Distinguished Service to Surgery.

PRINCIPAL FACULTY

The principal faculty of the MSPAS program includes Professor Darci Brown MSPAS, PA-C, a

board-certified physician assistant with 20 years of clinical practice, laboratory testing, and man-

agement experience. She has a Bachelor’s Degree in Forensic Chemistry from Buffalo State Col-

lege, having graduated Magna Cum Laude in 2000. After finishing her undergraduate degree, she

worked in a forensic laboratory prior to attending graduate school at Arcadia University where

she earned her Physician Assistant Studies degree. Professor Brown has also been a representa-

tive for the Pennsylvania Society of Physician Assistants for the past seven years and continues

to practice clinically with experience in family medicine, orthopedics and plastic surgery. On the

national level Professor Brown was elected as a member of the PAEA Finance Committee for a

two year term (2013-2015).

The Director of Didactic Education is Professor Abigail Davis MPAS, PA-C, a board-certified

physician assistant with over six years’ experience. Professor Davis graduated from Marywood

University in 2005 with a Bachelor Degree of Health Science and a Master's degree in Physician

Assistant studies. Immediately after graduation she began working in emergency medicine at a

Level 2 trauma center emergency room. She has been practicing emergency medicine for the

past seven years. During those years, she has been a clinical preceptor to Physician Assistant

students from multiple programs in the area. Professor Davis is a member of the Pennsylvania

Society of Physician Assistants for the past 3 years as well as the American Academy of Physi-

cian Assistants for the past eight years and volunteers at her son’s elementary school. On the na-

tional level Professor Davis was elected as a member of the PAEA End of Rotation Test Item

Writing Committee for a two year term (2013-2015). She continues to practice emergency medi-

cine part-time and lives in Dunmore with her husband and three children.

You will be assigned a faculty member as an advisor who will serve as your primary point of

contact while you are with us.

13 INSTRUCTIONAL FACULTY

We are fortunate to have access to qualified instructional faculty to assist in teaching some of our

non-clinical coursework. Basic science coursework in the MSPAS program is taught by univer-

sity faculty with expertise in an appropriate field. We also have a number of physicians, physi-

cian assistants, and other healthcare providers who will teach courses or lecture to you during

your time with us.

Dr. Anthony A. Serino Ph.D. is an Associate Professor of Biology and the Department Chair at

Misericordia University in Dallas, PA. Dr. Serino received his BS in Biology and his MS in Bi-

ochemistry from the University of Scranton in 1984 and 1987, respectively. In 1991, he earned

his Ph.D. in Physiology from The Pennsylvania State University. During his graduate tenure, Dr.

Serino was awarded a pre-doctoral fellowship from the National Institutes of Aging. Dr. Serino’s

teaching responsibilities include anatomy and physiology, general physiology, comparative anat-

omy, histology, gross anatomy and general biology. He has also received the Judge Max and Til-

lie Rosenn Endowed Excellence in Teaching Award at Misericordia University in 2005. Dr. Se-

rino maintains a residence in Shavertown, PA with his wife and four children.

Dr. Angela Asirvatham Ph.D. is an Associate Professor for the Biology Department of Miseri-

cordia University. She received her B.V.Sc., (Bachelor of Veterinary Sciences, Tamilnadu Veter-

inary & Animal Sciences University) in Chennai, India; her M.S. in Reproductive Biology from

University of Wyoming and her Ph.D. in Physiology from Kent State University. Dr. Asirvat-

ham’s postdoctoral work includes Pulmonary Physiology at the University of California and sig-

nal transduction in T-lymphocytes at Oregon Health Sciences University. Her research interests

focus on signal transduction in Schwann cells. Dr. Asirvatham teaches Immunology, General

Physiology and Endocrinology. She will be teaching Pathophysiology I and II for the PA pro-

gram. Dr. Asirvatham has also received the Judge Max and Tillie Rosenn Endowed Excellence

in Teaching Award at Misericordia University in 2012.

Dr. Frank DiPino Jr., PhD is a Professor for the Biology Department at Misericordia University.

Dr. DiPino received his PhD in Biology from Marquette University. His research area is in DNA

interactions. He has worked in clinical human cytogenetics at State University of New York Up-

state Medical Center and Valley Children's Hospital, Fresno California. He is a previous Chair of

the Biology Department and the Division of Mathematical and Natural Sciences at Misericordia

University. He teaches courses in Molecular Cell Biology, Developmental Biology, Molecular

Genetics and Human Genetics.

Dr. De Francesco Pharm.D. received his bachelor’s degree in pharmacy in 1994 from The Phila-

delphia College of Pharmacy and Science and doctorate in 2011 from Shenandoah University.

He maintains a practice site at Rite Aid Pharmacy in Wilkes-Barre Pennsylvania with a focus on

wellness, including adult immunizations. Dr. De Francesco also serves as adjunct faculty at

Wilkes University Nesbitt School of Pharmacy and Nursing. He will be teaching Pharmacology

for the PA program. In his free time he likes spending times outdoors and in the company of

family and friends.

14 DEPARTMENT ADMINISTRATIVE SUPPORT

Our support staff includes Mrs. Kathy Michael, Administrative Assistant to the Department of

Physician Assistant Studies; Diane Hopkins, Secretary to the Dean of the College of Arts and

Sciences, the Humanities Faculty, and the Department of Physician Assistant Studies; and Helen

Bogdon, Senior Secretary to the Mathematics and Natural Sciences Faculty.

CLINICAL PRECEPTORS

You will be assigned to a clinical preceptor at each of your clinical sites while on rotation during

the second year of the program. Your preceptor will set your schedule and guide you through the

daily routine of each rotation.

ADVISEMENT In the first professional year, students are assigned to a faculty member who will act as an advi-

sor for the duration of the MSPAS program. Faculty advisors will meet with students during the

semester to discuss academic progress and other issues. Students must take responsibility for

their own learning and will be asked to self-evaluate their progress by filling out the Mid-

Semester Advisement Sheet (see Appendix C – sample for fall semester) prior to meeting with

their advisor. Mid-semester evaluations will be placed in student files. Students with academic

concerns should address the issue first with the course instructor. Should a student require fur-

ther assistance, he/she should consult with the faculty advisor. The advisor will involve the Pro-

gram Director or other university administrative personnel as the situation warrants.

Your advisor will assist you in identifying areas of strength and weakness to help you focus your

studies. When problems arise, your advisor will discuss them with you in an attempt to clarify

your options and devise a plan of action.

Your advisor is not able to act as a medical provider for you. If you have a medical problem,

you should seek assistance from student health services or another provider.

Your advisor is also not able to act as a mental health counselor for you. If you have non-

academic problems that require formal counseling, your advisor will be happy to help you access

mental health services available at Misericordia.

Faculty schedules tend to be unpredictable due to clinical and research obligations. If you have a

non-emergent need, it is best to make an appointment with your advisor via telephone or email.

If you feel your need is emergent and your faculty advisor is not available, you may contact Scott

Massey, Ph.D., PA-C, Program Director for assistance.

15

PROGRAM ESSENTIAL FUNCTIONS

Working as a medical professional is often physically, mentally, and emotionally demanding. All

students receive a copy of the Program Technical Standards prior to matriculation. A copy of

these Standards may be found in this section for future reference.

The Misericordia University MSPAS program is committed to the education of all qualified in-

dividuals, including persons with disabilities who, with or without reasonable accommodation,

are capable of performing the essential functions of the educational program in which they are

enrolled and the profession that they pursue.

It is the policy of the program to comply with the Americans with Disabilities Act, Section 504

of the Rehabilitation Act of 1973, and state and local requirements regarding students and appli-

cants with disabilities. Under these laws, no otherwise qualified and competent individual with a

disability shall be denied access to or participation in services, programs, and activities solely on

the basis of the disability.

In accord with federal regulations established by the Americans With Disabilities Act, the fol-

lowing standards are described to assist each candidate in evaluating his/her prospect for aca-

demic and clinical success. General standards for the MSPAS program are followed by stand-

ards that apply to the professional discipline to which you have applied (see additional standards

below). When a student’s ability to perform is compromised, the student must demonstrate alter-

native means and/or abilities to perform the essential functions described.

It is important that you read each standard carefully. Each student is given the opportunity to

read and acknowledge their understanding of the standards prior to beginning of the program.

TECHNICAL STANDARDS, MSPAS

A candidate for the Misericordia University Master of Science in Physician Assistant Studies

program must have, at a minimum, demonstrably acceptable skills in observation, communica-

tion, motor, intellect and behavior/socialization. Reasonable accommodation for persons with

documented disabilities will be considered on an individual basis, but candidates must be able to

perform in an independent manner.

To qualify for admission to the Master of Science in Physician Assistant Studies program, candi-

dates must demonstrate to program principal faculty the ability to meet the following technical

standards in timed settings and under stressful conditions:

Sufficient capacity for observation in academic, clinical, and other medical settings; functional

vision, hearing, and tactile sensation sufficient to observe a patient’s condition and perform pro-

cedures regularly required during a physical examination

Sufficient skills to communicate verbally and in writing in academic and healthcare settings

Sufficient motor function to carry out movements necessary for patient diagnosis and care; for

free movement in patient care and between facilities and buildings in academic and healthcare

environments; physical stamina to complete didactic and clinical coursework

16

Sufficient intellectual ability to measure, calculate, reason, analyze, and synthesize, in the

context of medical problem-solving and patient care

Sufficient emotional health and stability required for exercising good judgment and promptly

completing all academic and patient care responsibilities

Professional Responsibility: Students must exhibit the ability to meet the challenges of any med-

ical situation that requires a readiness for immediate and appropriate response without interfer-

ence of personal or medical problems. This requires training for emergencies (e.g., CPR, infec-

tion control).

It is each student’s responsibility to attend and be able to travel to and from classes and clinical

assignments on time, and possess the organizational skills and stamina for performing required

tasks and assignments within allotted time frames. This involves frequent oral, written, and

practical examinations or demonstrations. The student must have the ability to perform problem-

solving tasks in a timely manner.

Students will exhibit adherence to policies of the university, their program, and clinical sites.

This includes matters ranging from professional grooming, dress, and behavior, to attending to

their program’s academic schedule, which may differ from the University’s academic calendar

and be subject to change at any time.

Students must demonstrate knowledge of and commitment to the code of ethics of their profes-

sion and behavior that reflects a sense of right and wrong in the helping environment. Students

will take initiative to direct their own learning. They need to work cooperatively and collabora-

tively with other students on assigned projects, and participate willingly in a supervisory process

involving evaluation of abilities and reasoning skills.

Additional standards relevant to specific discipline, Physician Assistant Program: In addition to

the general standards above, students applying to the Physician Assistant Program must consider

that they will be required to:

Participate in patient assessment and evaluation.

Participate in invasive and non-invasive procedures

Participate in emergency care

Work lengthy and irregular hours

Attend and participated in didactic and clinical education training on or off campus.

Perform physical examinations on male and female peers along with being examined by both

male and female peers during laboratory instruction.

DISABILITY SERVICES

In accordance with Section 504 of the Rehabilitation Act of 1973 and the Americans with Disa-

bilities Act (ADA) of 1990, students with documented disabilities may seek academic accom-

modations for their disability free of charge. These academic accommodations include extended

time on tests, use of a note sharer, and tape-recording of lectures.

17

PROFESSIONALISM

STANDARD C3.02 The program must document student demonstration of defined professional

behaviors.

The MSPAS Technical Standards consider the physical, cognitive, and behavioral abilities re-

quired for satisfactory completion of the physician assistant curriculum. The essential required

abilities for a physician assistant student include motor, sensory, communicative, intellectual,

behavioral, and social aspects. Academic, clinical, and professional development are intertwined

and related to each other. A student’s growth in the academic and clinical areas may be depend-

ent on their growth as a professional.

Physician assistant students must recognize themselves as clinicians providing services to both

the physician supervisor as well as to the patient. PA students must be aware that, even as stu-

dents, they are viewed by both patients and medical providers as part of the larger medical com-

munity. It is critical, therefore, that professional development be assessed, just as academic and

clinical skills are measured, during a student’s growth.

As healthcare practitioners, physician assistants are required to conform to the highest standards

of ethical and professional conduct. Physician assistant students also are expected to adhere to

the same high ethical and professional standards required of physician assistants.

The American Academy of Physician Assistants (AAPA) has identified four primary bioethical

principles – autonomy, beneficence, non-maleficence, and justice – that form the foundation of

the Statement of Values of The Physician Assistant Profession. The Statement of Values pro-

vides a guideline for ethical conduct by physician assistants. (A complete discussion of the ethi-

cal conduct required of physician assistants can be found at the American Academy of Physician

Assistant website, www.aapa.org). In addition to the AAPA’s guidelines, The National Com-

mission on Certification of Physician Assistants (NCCPA) recently adopted a code of conduct

for certified and certifying physician assistants. The NCCPA’s code of conduct “outlines prin-

ciples that all certified or certifying physician assistants are expected to uphold.” A complete

discussion can be found at http://www.nccpa.net/CER_process_codeofconduct.aspx.

In addition to understanding and complying with the principles and standards promulgated by the

AAPA, the NCCPA, and the Accreditation Review Commission on Education for the Physician

Assistant (ARC-PA), physician assistant students are required to know and comply with the poli-

cies, procedures, and rules of the Master of Science in Physician Assistant Studies program and

the university (including, without limitation, the Guiding Principles of Conduct that may be

found in the Misericordia University Student Handbook); and the policies, procedures, and rules

of each clinical site to which the student is assigned. Further, physician assistant students are

required to conduct themselves in a manner that complies with the following principles and

standards:

18 RESPECT

Physician assistant students are expected to treat all patients, faculty, staff, clinical preceptors,

healthcare workers, and fellow students with dignity and respect. For example:

• Physician assistant students must recognize and embrace their roles as members of a

team and interact with others on the team in a cooperative and considerate manner.

• Physician assistant students train closely with other students, including in physical

examinations of fellow students and discussion groups that may reveal personal in-

formation. Students must maintain and exhibit respect for the privacy and confidenti-

ality of fellow students.

• Students should offer criticism or suggestions in a thoughtful and reasoned manner

that fosters respect and trust.

• When confronted with conduct by another member of the team that may be inappro-

priate, students are not to respond angrily; rather, they must remain calm and respect-

ful, and respond in accordance with the standards of professional conduct required of

physician assistant students.

FLEXIBILITY

Although every effort is made to provide training activities at times and places scheduled in ad-

vance, physician assistant students often will be required to be flexible because of changes in the

schedule. For example, instructors who are also practicing clinicians may not have a regular

schedule, and lectures or clinical sessions may, at times, need to be rescheduled with short no-

tice. In addition, clinical sites create the student schedules for each rotation, and such schedules

may require physician assistant students to work weekends and nights.

HONESTY AND TRUSTWORTHINESS

Physician assistant students shall be honest and truthful in all respects. Students shall not inten-

tionally mislead others.

STUDENT ROLE AND ACCOUNTABILITY

Physician assistant students have a unique role in health care delivery. In that role, students are

accountable for such things as:

• Students shall perform only those procedures authorized by the program, clinical site,

supervisor, and/or preceptor.

• Physician assistant students at clinical sites must always work under the supervision

of a preceptor, and are prohibited from assuming primary responsibility for a patient’s

care. For example, students shall not treat or discharge a patient without prior consul-

tation with, and approval of, a clinical preceptor or supervisor.

19

• Students are responsible for timely completion of all assignments and duties effec-

tively and to the best of their ability.

• Students are responsible for identifying and reporting unprofessional, unethical,

and/or illegal behavior by healthcare professionals and students, faculty, and staff of

the MSPAS program. If a physician assistant student has a reasonable belief that

such conduct has occurred, he or she should report it to the Program Director, precep-

tor, supervisor, or faculty advisor, as may be appropriate under the circumstances.

• Physician assistant students are expected to accept and apply constructive feedback.

Physician assistant students are always required to exercise sound judgment.

CONCERN FOR THE PATIENT

Physician assistant students must, by their words and behavior, demonstrate concern for the pa-

tient. Concern for the patient is manifested in many ways, including, but not limited to, the fol-

lowing:

• Physician assistant students must treat patients and their families with dignity and re-

spect.

• At all times, the physical and emotional comfort of the patient are of paramount im-

portance.

• Students must use appropriate verbal and non-verbal communication to convey con-

cern, pleasantness, compassion, and professionalism to the patient.

• The patient’s modesty should be considered and respected at all times.

• Students shall deliver healthcare services to patients without regard to their patients’

race, religion, national origin, age, sex, marital status, citizenship, sexual orientation,

creed, disability, medical condition, socioeconomic status or political beliefs, or any

status protected by law.

• Students may not accept gifts or gratuities from patients or their families.

• Sexual or romantic relationships with patients are prohibited and will not be tolerated.

PROFESSIONAL APPEARANCE

A professional appearance demonstrates respect for patients and helps to build their confidence.

Physician assistant students must dress in professional, neat, and conservative attire. Good per-

sonal hygiene is always required.

Guidelines for all Program Related Experiences (the First Professional Year)

All students will be expected to wear business casual attire

No hats (men and women)

20

No shorts, sweats or cutoff pant legs

No midriff, or halter tops

No body jewelry/piercing that interferes with class function, especially during laboratory ses-

sions

No visible tattoos

No open-toed shoes during laboratory sessions in which sharps are handled

Dress requirements for physical examination laboratory sessions may be found in the appropriate

course syllabus. Scrubs may be worn for Gross Anatomy Laboratory only.

When required to be present at clinical sites, please observe guidelines below.

Guidelines for All Clinical Experiences (in addition to the criteria noted above)

STANDARD B3.01 PA students must be clearly identified in the clinical setting to distinguish

them from physicians, medical students, and other health profession students and graduates.

Professional dress is necessary for all clinical experiences and evening classes/meetings:

Students will wear a clean, short white “consultation jacket”

Males should wear a collared shirt with a tie

Hair should be worn in a neat manner

All attire will be clean and pressed

Jeans, shorts and cutoffs are prohibited

Open toed shoes are prohibited, sneakers when wearing scrubs only

Students must display prominently at all times their nameplate issued from Misericordia

University, which contains the student’s name and the title “Physician Assistant Student”

(supplied by the program).

Any additional dress requirements imposed by a clinical site supersede those of the program.

“Scrubs” should be worn in accord with facility policy. In general, they should not be worn

outside of the operating or delivery room. Soiled scrubs should be left at the facility for

laundering at the end of the assigned shift. Scrubs are not permitted on campus except as

previously noted.

Students who appear in class or at a clinical site with inappropriate attire or hygiene may be di-

rected to leave, and will not be permitted to make up missed assignments.

MAINTAINING COMPOSURE

Physician assistant students must maintain a professional and calm demeanor at all times, even in

emergency and other highly stressful situations.

DRUGS AND ALCOHOL

Physician assistant students must comply with the University’s Drug and Alcohol Policy and all

other applicable policies and procedures concerning the use of drugs and alcohol at clinical sites.

21 All students must successfully complete a drug screen exam prior to entering the didactic phase

of the program as well as a repeat exam prior to entering the clinical phase of the program. A

clinical site may request additional drug screens prior to entering their site or during the rotation.

Students must comply with this request or risk failure of that clinical rotation. Students are pro-

hibited from appearing at any clinical site while under the influence of alcohol or any drug that

may affect performance or judgment. Drug screens are conducted at the student’s expense.

TIMELINESS AND ATTENDANCE

Attendance and timeliness are important aspects of professional behavior. Students must report

to all classes, laboratories, seminars, call-back days, clinical sites, and other scheduled activities

on time. Timely return from designated breaks is required. Students must return messages from

program staff, faculty, clinical preceptors, and clinical sites in a timely manner (i.e., in less than

36 hours). Students must submit all required assignments and forms on or before the designated

date, and/or time, they are due. In formal classroom and clinical situations, students should ad-

dress faculty and lecturers using the appropriate form of address (Professor/Doctor). Under no

circumstances are children allowed in the classrooms during formal lectures.

CRIMINAL BACKGROUND CHECKS

Candidates for admission must satisfy a Level One criminal background check before being ac-

cepted to the program and have this updated prior to entering the clinical phase. This back-

ground check is carried out at the prospective student’s expense.

PROFESSIONAL DEVELOPMENT ASSESSMENT TOOL

The professional conduct of physician assistant students is evaluated on an on-going basis

throughout the didactic and clinical years of the program. Violations of standards of conduct are

subject to disciplinary actions administered by the university, and by the program.

As a PA student, you are expected to achieve the highest level of professionalism. The Profes-

sional Development Assessment Tool (PDAT) (see Appendix D) is an example of an assessment

tool that will be used to determine if you have achieved professional competency to graduate and

practice as a physician assistant. This instrument is completed at the end of each semester by

your faculty advisor and upon completion of the program.

If there are issues in professional behaviors that occur during the course of a semester, your advi-

sor and/or the Program Director will request a meeting with you to discuss any concerning

behavior. The PDAT will be used to document such behaviors and will remain in the student file

for the remainder of the academic year. If the behavior does not improve, the student can be sub-

ject to reprimand, disciplinary probation, or dismissal.

STUDENT CONDUCT IN CLINICAL FACILITIES

Students enrolled in the MSPAS program are expected to conduct themselves in a professional

manner at all times. The criteria for evaluating professional performance include, but are not lim-

ited to, demonstrating professional competencies and skills; adhering to program and facility pol-

icies; displaying sensitivity to patients’ and community needs; demonstrating an ability to relate

22 appropriately to peers and other members of the health care team; displaying a positive attitude;

maintaining regular and punctual attendance; and maintaining acceptable physical appearance.

CONCLUSION

The requirements for professional performance have been established to protect the rights of pa-

tients and communities and to foster the team concept in the delivery of health care. More de-

tailed information may be found in Part II of this manual.

CURRICULUM AND ACADEMIC POLICIES

STANDARD B1.02 The curriculum must include core knowledge about established and evolving

biomedical and clinical sciences and the application of this knowledge to patient care.

STANDARD B1.03 The curriculum must be of sufficient breadth and depth to prepare the student

for the clinical practice of medicine.

STANDARD B1.04 The curriculum design must reflect sequencing that enables students to de-

velop the competencies necessary for current and evolving clinical practice.

PROFESSIONAL PHASE CURRICULUM

The courses offered by the MSPAS program have been specifically designed and sequenced to

prepare students to administer health care to patients. According to the ARC-PA 4th

Edition

Standards, the program curriculum should prepare students “to provide patient centered care and

collegially work in physician-PA teams in an inter-professional team environment. The curricu-

lum establishes a strong foundation in health information technology and evidence-based medi-

cine and emphasizes the importance of remaining current with the changing nature of clinical

practice.”

Further, according the ARC-PA 4th

Edition Standards, the professional curriculum for PA educa-

tion should include, “applied medical, behavioral and social sciences; patient assessment and

clinical medicine; supervised clinical practice; and health policy and professional practice is-

sues.”

In accordance with the ARC-PA Standards and with the desire to graduate competent health

practitioners who are capable of delivering high quality health care, rigorous academic standards

have been established for continued matriculation in the MSPAS program. Students are ex-

pected to complete all course assignments as outlined in the individual course syllabus and to

meet the university’s academic standards as outlined in this manual. Students will be given up-

dates to these standards as they occur.

23

Class of 2015

Curriculum Outline - Year I

Fall Semester

PA 526 Introduction to the Profession 1 credit

PA 530 Clinical Medicine I 5 credits

PA 538 Patient Assessment I 4 credits

PA 544 Gross Clinical Anatomy 3 credits

PA 541 Pharmacology I 2 credits

PA 546 Physiology / Pathophysiology I 2 credits

PA 560 Clinical Genetics 1 credit

Total 18 credits

Spring Semester

PA 527 Health Care Issues I 2 credits

PA 531 Clinical Medicine II 6 credits

PA 539 Patient Assessment II 4 credits

PA 542 Pharmacology II 3 credits

PA 547 Physiology / Pathophysiology II 2 credits

Total 17 credits

Summer Semester

PA 528 Health Care Issues II 1 credit

PA 532 Clinical Medicine III 3 credits

PA 543 Pharmacology III 2 credits

PA 550 Emergency Medicine 2 credits

PA 552 Medical Procedures & Surgery 2 credits

PA 554 Special Populations 5 credits

PA 560 Research, Epidemiology and Statistics 2 credits

Total 17 credits

All course descriptions may be found on our Web site and in the university’s catalog for the

academic year.

24

Curriculum Outline - Year II

Professional Year II clinical rotations include rotations in:

PA 601 Ambulatory Medicine 5 weeks 5 credits

PA 603 Internal Medicine 5 weeks 5 credits

PA 604 Pediatrics 5 weeks 5 credits

PA 605 Psychiatry 5 weeks 5 credits

PA 606 Surgery 5 weeks 5 credits

PA 607 Women’s Health 5 weeks 5 credits

PA 608 Emergency Medicine 5 weeks 5 credits

PA 609 General Elective Rotation 5 weeks 5 credits

PA 609 General Elective Rotation(2) 5 weeks 5 credits

PA 610 Research Rotation 4 weeks 0 credits

Clinical Clerkships 45 credits

PA 631 Professional Development 1 credit

PA 632 PANCE Preparation 2 credits

PA 633 Summative Evaluation 1 credit

Total 49 credits

Commencement held in December following Year II. The MSPAS degree is granted after

summer semester.

ACADEMIC PERFORMANCE STANDARDS

Preparing for a career in the health sciences is a rigorous undertaking. Practitioners are expected

to possess not only excellent clinical skills, but also to practice according to the highest ethical

and professional standards. Preparation for meeting these high standards begins during a stu-

dent’s education. Some students may occasionally experience academic difficulties. Such diffi-

culties are best addressed early, before they grow to an unmanageable size.

As practitioners, students will be expected to exercise sound clinical judgment. As students, it is

also important to exercise sound academic judgment and seek academic assistance when neces-

sary. Students should consult with course instructors, academic advisors, and/or the Program Di-

rector as soon as a difficulty becomes apparent.

Admission Requirements

The MSPAS curriculum is open to applicants who have earned, or will earn, by the end of the

summer semester prior to fall semester entry, a baccalaureate degree and have met, or will have

met, by the end of the summer semester prior to fall semester entry, the following prerequisites:

An earned bachelor’s degree with an overall cumulative grade-point average (GPA) of 3.0 on a

scale of 4.0

A minimum average of 3.0 on a scale of 4.0 in required pre-requisite courses

25

A minimum average of 3.0 on a scale of 4.0 in the sciences as figured by Central Application

Service for Physician Assistants (CASPA )

Ability to fulfill all university admission requirements

Successful completion (as defined above) within ten years prior to admission of the following

undergraduate science courses with laboratory components, to total 48 or more semester hours:

o General Biology I and II

o General Chemistry I and II

o Anatomy and Physiology I and II

o Microbiology

o Organic Chemistry I and II

o Biochemistry

o Three Biology, Chemistry, Biochemistry and /or Psychology elective courses

Completion of the GRE

Submission of a letter of recommendation from a healthcare provider (MD, DO, PA, or NP)

Successful completion of an interview with, and positive recommendation by, program principal

faculty

Satisfactory Level 1 Criminal Background Check

Satisfactory Drug Screen

Demonstration to program principal faculty of ability to meet the following technical standards:

o Sufficient capacity for observation in academic, clinical, and other medical settings; func-

tional vision, hearing, and tactile sensation sufficient to observe a patient’s condition and

perform procedures regularly required during a physical examination

o Effective written and verbal communications skills sufficient to both academic and

healthcare settings

o Sufficient motor function to carry out movements necessary for patient diagnosis and

care; for free movement in patient care and between facilities and buildings in academic

and healthcare environments; physical stamina to complete didactic and clinical course-

work

o Sufficient intellectual ability to measure, calculate, reason, analyze, and synthesize, in the

context of medical problem-solving and patient care

o Sufficient emotional health and stability required for exercising good judgment and

promptly completing all academic and patient care responsibilities

Progression Requirements

In addition to fulfilling university requirements and following all university policies for graduate

program standing and progression, students enrolled in the MSPAS curriculum or entering from

a proposed undergraduate component (please see below) must observe the following progression

requirements:

Adherence to all course pre-requisites

Adherence, as developmentally appropriate, to codes and standards of the Physician Assistant

profession and demonstration of generic abilities in professional behavior

Maintenance of good program standing, as defined by the university, for entrance into the

clinical year of the curriculum

Demonstration, as is developmentally appropriate, of progress toward graduation competencies

of the MSPAS curriculum

26

Progression from the third year of the 3+2 undergraduate component to the didactic year

of the MSPAS curriculum is open to matriculants of the undergraduate component who have

met, or will have met, by the end of the summer semester, prior to fall semester didactic year

coursework, the following pre-requisites:

All required science courses, electives, and core curriculum courses completed prior to entrance

into didactic coursework

A minimum average of 3.0 in required science courses

A minimum cumulative grade point average of 3.0

A minimum grade of C minus in all courses at the 100 through 400 levels

Completion of 50 hours shadowing a Physician Assistant (must be PA, not MD, DO, or NP)

Completion of 100 hours of community service (must be from freshman orientation forward)

Maintenance of good academic standing, as defined by the university

No record of university disciplinary sanction

Satisfactory Level 1 Criminal Background Check

Satisfactory Drug Screen

Successful completion of an interview with, and positive recommendation by, program principal

faculty

Demonstration to program principal faculty of ability to meet the following technical standards

in timed settings and under stressful conditions:

o Sufficient capacity for observation in academic, clinical, and other medical settings; func-

tional vision, hearing, and tactile sensation sufficient to observe a patient’s condition and

perform procedures regularly required during a physical examination

o Sufficient skills to communicate verbally and in writing in academic and healthcare set-

tings

o Sufficient motor function to carry out movements necessary for patient diagnosis and

care; for free movement in patient care and between facilities and buildings in academic

and healthcare environments; physical stamina to complete didactic and clinical course-

work

o Sufficient intellectual ability to measure, calculate, reason, analyze, and synthesize, in the

context of medical problem-solving and patient care

o Sufficient emotional health and stability required for exercising good judgment and

promptly completing all academic and patient care responsibilities

Progression Requirements to Progress from Didactic Year to Clinical Year:

1) Cumulative GPA of 3.0 for Didactic year

2) Satisfactory completion of update on Level 1 background check

3) Satisfactory drug screen

4) Satisfactory score on professional assessment

5) Students must also satisfactorily complete the complete history and physical

OSCE at TCMC

All of these components must be satisfied in order for a didactic year PA student to progress to

the clinical phase of the program. Failure of any component will result in dismissal from the pro-

gram.

27

Other Academic Standards and Policies

1. All students must maintain a GPA of 3.0 or better to remain in good program academic standing.

2. Students must receive a minimum grade of C in all MSPAS courses during the didactic year. If

the student earns a grade below C this will result in the student being suspended. Students wish-

ing to be allowed to repeat an academic course must petition the program director and return the

next year to repeat the course prior to progression. If the student earns less than a C in more than

one course at any point in the didactic year the student will be dismissed permanently.

3. If the student earns a grade below C in a clinical rotation this will result in the student decelerat-

ing. Students wishing to repeat a rotation must petition the program director and complete the

additional rotation at the end of the scheduled program delaying their graduation.

4. The academic standing of each student will be reviewed at the end of each academic semester.

5. For students whose academic status is not consistent with program/course expectations, faculty

members will submit mid-semester warning in accordance with university-designated dates and

procedures.

6. Violation of the Honor Code, Code of Ethics and/or Program or University Policies in any way

may be subject to reprimand depending on the severity of the violation.

7. Students whose academic status is not consistent with program/course expectations at the end of

a semester may be subject to the following:

Academic Probation

A student with a cumulative GPA below 3.0 shall be placed on academic probation and receive a

letter from the Program Director stating such. This written notice of probationary status will also

include a notice that failure to reach the required GPA by the end of the designated academic

semester may result in his/her dismissal from the program.

Each student on probation is required to meet with the Program Director and academic advisor

by the end of the second week of the probationary semester to develop and agree to-in writing-an

Academic Improvement Plan (AIP). The AIP may include mandatory study/advising sessions, or

other stipulations aimed at encouraging and supporting student success. A copy of a student’s

AIP will be maintained in his/her advising folder, and a copy will also be forwarded to the office

of the Dean of the College of Arts and Sciences.

Program probationary status may remain in effect for up to two consecutive academic terms, de-

fined as two semesters, or two clinical clerkships.

It is expected that students on probation make progress toward good academic standing at the

conclusion of each academic term. Failure to demonstrate improvement at the end of the first

probationary period may result in dismissal.

At the conclusion of the second consecutive academic term, the student must have achieved good

academic standing; failure to do so will result in dismissal.

Upon completion of each academic term, a student on academic probation will receive in writ-

ing, from the MSPAS Program Director, a notice of his/her current standing.

28 Academic Suspension

A student may be placed on Academic Suspension for:

Receiving a grade of less than C in any class

A breach of professionalism

A violation of the Code of Ethics

A breach in Academic Integrity

A violation of the Student Code of Conduct as defined by the University

Being dismissed from a clinical rotation for any reason

Students, who have been suspended from the program for any reason, including violation of pro-

fessionalism or academic policy, must apply in writing for readmission to the Program Director

prior to the fall semester of the next academic year. Students may be required to audit courses,

repeat coursework, or pass written and/or practical examinations to demonstrate competence be-

fore returning to the program.

Academic Dismissal

Each student’s academic status will be reviewed at the end of each academic semester. Each stu-

dent’s cumulative GPA will be determined. A student whose GPA falls below the level of good

academic standing, as defined by the program requirements, for two academic semesters or who

fails two clinical rotations will be automatically dismissed from the program.

Student Grievance Policy

For Student Grievance Policy please refer to the University Student Handbook.

Evaluations

1) Student Evaluation of Clerkship: During the clinical year students are required to evaluate each

clerkship and complete the evaluation at the end of each rotation (see Appendix N). The

information from these evaluations will be used to update the data on each clinical site, correct

deficiencies if present, and as a resource for placing future students in that site. These data will

be entered on E*Value.

2) Preceptor Mid-Rotation and Final Evaluation of Student Performance: The student is to remind

and encourage the preceptor to perform a mid-rotation evaluation to point out strengths and

weaknesses that the student has demonstrated during the first-half of the rotation (see Appendix

L). In this way, students are able to work on those areas of weakness for the remainder of the

rotation. The preceptor is responsible for evaluating student performance during the clerkship at

the end of the clerkship as well and is encouraged (but not required) to discuss this evaluation

with the student prior to the completion of the rotation. Students are evaluated on their basic

medical knowledge and ability to obtain a medical history and to perform an appropriate physical

examination. In addition, students are evaluated on interpersonal and communication skills,

professionalism, practice-based learning, and systems-based learning.

29

3) Grading: Students are expected to maintain their overall GPA minimum of 3.0 in order to remain

in good academic standing in the MSPAS program. If a student receives a final grade that is

below a C, the student must repeat that rotation and will result in the student being placed on

academic probation (depending on cumulative GPA). A student cannot receive a grade less than

a C in more than one course . The final grade of each rotation is determined by multiple factors

including the preceptor evaluations; the oral presentation, attendance at Professional Seminars,

professionalism, completion of required electronic entries, and the end-of-rotation exam grade

(see individual syllabi). The Director of Clinical Education will determine the final grade for

each rotation.

Students must demonstrate competency in all six categories on their final evaluation from the

preceptor. Each category must show a score with a minimum average a (2) or greater, regardless

of the final average. If the student receives less than a (2) average on one of the following

competency domains the director of clinical education will investigate this result which may

include speaking to the preceptor and the student. The director of clinical education has the

authority to modify a grade received from a preceptor based upon her investigation. If a student

fails to demonstrate this minimum competency in ANY section (1 through 5) on their final

evaluation, that student must repeat that rotation. The evaluation system is presented

below (see also Appendix M):

For each of the following sections, please indicate the degree to which each of the statements

is reflective of student performance. Please use the following scale in your evaluation:

5 Consistently exceeds expectations; outstanding performance

4 Occasionally exceeds expectations; above average performance

3 Meets expectations; average performance

2 Occasionally meets expectations; below average performance

1 Does not meet expectations; poor performance

N/A Not applicable to this clinical experience

The above evaluation system is applied to the following categories:

Medical Knowledge

Patient Care

Interpersonal and Communication Skills

Professionalism

Practice-based Learning

Systems-based Learning

All required clinical rotations must be satisfactorily completed as judged by the Program

Director before the student can be recommended for graduation from the program.

If the student is not performing at an acceptable clinical and professional level at the rotation site

and is either removed or dismissed from the site prior to the end of the rotation due to poor

performance or unprofessional behavior; an investigatory process will be completed by the

Director of Clinical Education. If it is determined that the student earned a less than satisfactory

grade (less than “C”) for that rotation, that student will have to repeat the rotation in its entirety.

30 Once again, depending on the academic standing status of that student , he/she may be subject to

dismissal from the program.

Students are expected to behave in a professional manner consistent with the Professionalism

Guidelines for the PA Student (see Appendix Q). At the end of the first year, a formative

evaluation of each student will be done using the Professional Development Assessment Tool

(PDAT) (see Appendix D). At the end of the second year, a summative evaluation of each

student will be done as well using the Professional Development Assessment Tool. Students

must achieve competency in all areas of professional behavior to receive a recommendation to

graduate from the Program Director.

Students are subject to dismissal from the program if any of the following exist:

a. Student fails to obtain a “C” or greater in a repeated rotation

b. Student fails to obtain a “C” or better in two (2) required rotations

c. Student is found to be deficient in the professional competencies

d. Student is unable to maintain an overall minimum GPA of 3.0

Students will be closely monitored throughout their clinical year. Preceptors are required to

notify the Director of Clinical Education immediately upon having concerns about a student in

order that necessary remedial work can begin as soon as possible.

4) End of Rotation Examination: Students will take End of Rotation Examinations held at the

University. End of Rotation Examinations will be primarily multiple-choice, to simulate the Na-

tional Board Examination; however, other types of testing methods may be used such as problem

oriented clinical examinations, Objective Structured Clinical Evaluation (OSCE), case studies,

etc. There is an End of Rotation Examination (unless otherwise specified) for all nine rotations.

Distance EOR and Call Back Policy: Students on clinical rotations who are completing 2 se-

quential rotations at a greater than 500 mile distance from the campus may be allowed to com-

plete their EOR exam and professional development lectures and/or activities via distance learn-

ing methods.

An adequate exam Proctor must be available and approved by the Director of Clinical

Education or the Program Director.

Distance learning methods must be available to both student and faculty in order to be

able to deliver the professional development lectures and materials adequately.

EOR exams and call back may never be completed at a distance directly following an in-

ternational rotation, or take place when PACKRAT, Summative I, or Summative II ex-

ams are taking place.

The program director must approve any distance EOR or call back situations

The student may only complete one Call Back at a distance site

5) Professional Seminar: Students are required to attend mandatory 1 or 2-day seminars at a desig-

nated site. Students are required to attend all scheduled seminars. Absence from any Profes-

sional Seminar requires a documented and approved excuse. Dates for these seminars will be

given to the students prior to the beginning of their clinical year. Students are expected to pre-

sent orally one case of a patient they have followed each semester during the clinical year and

31 are evaluated on the presentation. The presentation will be evaluated as Pass/Fail. If the student

does not receive a grade of “Pass,” a grade of “Incomplete” will be assigned for that rotation un-

til the student achieves competency. A maximum of two attempts will be allowed for the presen-

tation. If the student does not Pass the presentation after the second attempt, the rotation will be

failed and must be repeated at the end of the program, thus delaying graduation. All electronic

entries are due by the Sunday following Professional Seminar for that rotation.

6) Summative Evaluation: This course provides a summative evaluation tool to measure cognitive,

motor, and affective domains at a point near students’ completion of the program. Students per-

form an objective standardized clinical examination (OSCE) in order to demonstrate competency

in interpersonal skills, comprehensive physical examination skills, and professional bearing. Stu-

dents complete an end-of-course written examination providing proof of medical knowledge and

clinical competence.

7) Professional Development: Course topics include résumé development, employment strategies,

completing of state applications for practice, medical malpractice, reimbursement issues, and fi-

nancial planning.

8) PANCE Preparation: This course prepares students for successful completion of the Physician

Assistant National Certifying Examination (PANCE), necessary for entering medical practice.

Students learn strategies for successful study and successful completion of board-style exams.

This course integrates study on clerkships and comprehensive review of all topics on the Nation-

al Commission on Certification of Physician Assistant (NCCPA) blueprint.

Leave of Absence

The University does not recognize leaves of absence from graduate academic programs.

Sanctions

Students who fail to meet the academic standards outlined may be subject to academic sanctions

including academic probation, suspension, establishment of a learning contract, and/or dismissal.

Program Probation

Grounds for being placed on academic probation include, but are not limited to:

Failure to maintain a cumulative GPA above 3.0;

Course failure;

Lapses in professionalism.

32 Program Suspension

All courses in the MSPAS program are offered only once an academic year and serve as pre-

requisites for subsequent courses. In the event of course failure, a student may be suspended

from taking subsequent courses until the failed course is successfully retaken.

In the event that a student is found to pose a danger to themselves, faculty, staff, or patients at

clinical sites, the student may be suspended until the situation is investigated or the student is

dismissed from the program.

Learning Contract

A learning contract is a document employed by the program in cases in which a student’s per-

formance fails to meet expected standards. The contract describes how a student’s performance

has been deficient and outlines steps that should be taken to remediate a deficiency or improve

performance. . The student's advisor can implement a learning contract at any point during the

didactic year. The stipulations and recommendations for the student’s academic improvement

will be described on this document. A copy of this document will be signed by the student and

faculty member. This contract will remain in the students file until graduation. During the clini-

cal year a learning contract will be initiated if the student does not achieve certain numerical

benchmarks in the formative and summative examinations which are part of the PANCE prepa-

ration system. Learning contracts may be established independently of or in addition to one of

the above sanctions. Failure to comply with the conditions established in a learning contract

constitutes grounds for further disciplinary action, including dismissal.

Program Dismissal

Grounds for program dismissal include, but are not limited to, the following:

Failure to raise the cumulative GPA above 3.0 at the completion of two academic program

semesters of probation (this includes the summer session)

Achieving grade less than C in more than one course

Failure to meet conditions established in a learning contract

Lapses in professionalism*

*Students are subject to the university’s Student Code of Conduct found in the Student

Handbook

STANDARD A3.11 The program must define, publish and make readily available to faculty and

students the policies and procedures for processing student grievances and allegations of har-

assment.

Page 14 of the University’s Student Handbook provides a definition and procedure for members

of the university that perceive any potential harassment:

All employees and students have the right to work, learn, and study in an environment free

from all forms of discrimination and conduct which can be considered harassing, coercive, or

disruptive. Accordingly, it is the policy of the University that no member of the campus

33

community may engage in conduct that is abusive to others. This includes any discriminato-

ry, hostile, or hateful act toward another person’s personal, educational, or professional inter-

ests based on the individual’s race, color, gender, age, sexual orientation, marital status, reli-

gion, national origin, political affiliation, disability, or Vietnam or disabled veteran status.

The university has special procedures for handling harassment or discrimination complaints.

Students who believe they have been a victim of harassment should contact the Dean of Stu-

dents. The Office of the Dean of Students is located in the Banks Center and can be contacted

at extension 6304.

PHYSICIAN ASSISTANT PROGRAM SPECIFIC GUIDELINES

Credits for graduation will be granted only for those courses in which a passing grade is earned

as described in that course’s syllabus. In order to progress in the program, students must achieve

and maintain a minimum cumulative grade point average equivalent to a “B” (3.0).

Students failing a test should consult the course syllabus and instructor for direction. If a student

fails a course within the MSPAS curriculum, the student will not be allowed to continue into the

next semester, nor can she or he enroll in any other PA courses until the failed course has been

retaken and successfully completed. Students may not progress to the clinical phase of the

MSPAS program without successful completion of all didactic courses.

Incomplete Grades

Students who are enrolled in the didactic phase of the program must remove an incomplete grade

prior to the beginning of the next semester. Failure to complete the course work assigned by the

start of the next semester will result in the assignment of a failing grade.

Academic Difficulties and Progression

The academic progress of students enrolled in the didactic phase of the program will be evaluat-

ed in terms of successful completion of courses as determined by the standards established by

each respective course instructors. The MSPAS program curriculum is highly integrated and de-

velops sequentially from coursework done in previous semesters. If a student fails a course with-

in the curriculum, the student will not be allowed to continue in the next semester until the failed

course has been retaken and successfully completed. Students who do not successfully remedi-

ate the failed course or who fail a second course within the PA curriculum will be dismissed.

Failure to complete all course requirements will result in a failing grade for the course.

Grade-point-average calculation will be based only on courses taken in the PA program – Profes-

sional Phase. Thus, in the first year of the program, GPA will be based on grades in PA courses.

34

Remediation

STANDARD C3.03 The program must monitor and document the progress of each student in a

manner that promptly identifies deficiencies in knowledge or skills and establishes means for

remediation.

The MSPAS program curriculum is a rigorous process that requires full commitment from both

the students and the faculty. Thus, the program uses an “Early Alert System” to recognize stu-

dents who may be experiencing academic or clinical difficulties and to offer help at the earliest

possible time in the semester and in the curriculum. As described earlier, each student is assigned

a faculty advisor. During regular faculty meetings, faculty members are informed of all student

grades across the curriculum. Faculty also share reports on how their advisees are doing

throughout the curriculum.

To preemptively facilitate the development of effective study skills there will be a series of study

skills seminars conducted by the program director and the faculty during several sessions sched-

uled in the recitation slots during the first few weeks of the program. Students will be required to

complete assignments such as learning style indicators. These sessions are mandatory and are

paramount for improving the student’s likelihood of success in the PA program

Students who are identified as having academic difficulty will be contacted by their advisor who

will meet with them to identify problems and offer solutions. Further, faculty will complete a

Student Academic Mentoring Form (see Appendix F) with the student detailing what remedia-

tion efforts have been suggested, and will follow the student’s progress carefully thereafter.

Students may be referred to one or more of the following services as needed:

Referred to tutoring services

Referred to Disability Services

Referred to course coordinator/instructor

Referred to Program Director – study skills

Referred to mental health counseling services

ACADEMIC INTEGRITY

A career in medicine requires integrity. It is expected that all students will act in recognition of

this requirement. Medical education is stressful, and sometimes otherwise well-intentioned peo-

ple are tempted to make poor decisions. If you experience difficulty, please contact your course

instructor or faculty advisor for guidance. This section contains information regarding the pro-

gram’s expectations for academic integrity.

35 POLICY ON ACADEMIC HONESTY AND INTEGRITY

STANDARD B1.05 The curriculum must include instruction about intellectual honesty and ap-

propriate academic and professional conduct.

In order to ensure that the MSPAS program graduates are competent and ethical practitioners,

the faculty of the program has developed the following information regarding academic honesty

and integrity. This information will be reviewed with all students entering the program during

orientation. Students will be given a short quiz to demonstrate their understanding of policies

related to academic integrity. It is the responsibility of the student to visit these policies regularly

to refresh their understanding.

The University’s policy found on page 24 of the Student Handbook states the following:

Student Code of Conduct

Misericordia University is a Catholic institution sponsored by the Religious Sisters of Mercy.

The Core Values of Mercy, Service, Justice and Hospitality permeate the university commu-

nity. In an effort to promote individual and collective responsibility among its members, the

University has adopted certain regulations which act as guiding norms in the governance of

student conduct. Students are required to engage in responsible social conduct grounded in

the core values that reflect positively upon the university community, and to model good citi-

zenship in any community. All students attending this institution are responsible for adhering

to University policies as highlighted in this publication, the academic catalog, and other Uni-

versity publications. The student code shall apply to a student’s conduct even if the student

withdraws from the school while a disciplinary matter is pending. The Dean of Students shall

decide at his/her discretion, whether the student code shall be applied to conduct occurring

off campus on a case by case basis.

Definitions of Academic Dishonesty

Academic Integrity

Any form of cheating or dishonesty, including plagiarism, is a fundamental violation of the

nature and purpose of Misericordia University. Such behavior will not be tolerated and will

result in at least lowered grades, possibly failure in a class, program dismissal, and, in the

most serious cases, dismissal from the University. Plagiarism is using someone else’s ideas

or words and claiming them as one’s own. Students who use another person’s words must

copy them accurately, enclose them in quotation marks, and identify the source clearly. If

another person’s ideas are used in a student paper, the source must still be identified and the

author of the ideas given credit. Students are responsible to make sure that they are using

sources properly and documenting them properly.

The responsibility for maintaining personal integrity and honor in academic activities rests

with the student. Each faculty member will provide information on academic integrity to stu-

dents in the course outline at the beginning of the semester, including any necessary explana-

tion of violations, possible infractions of academic integrity, and the scope of sanctions, e.g.,

36

warning, lowering of the grade on the assignment or course, course failure, or dismissal from

the program or university.

Should a violation of academic integrity occur; the faculty member must inform the student

of the violation before imposing any sanction. Should the violation be considered serious

enough to merit any grade of a “D” or lower on any major assignment, or a more serious

penalty, such as course failure or dismissal from the program, the faculty member must noti-

fy the Vice President of Academic Affairs (VPAA) and supply any supporting evidence. In

the case of multiple violations, the VPAA will discuss this issue with the student and may

impose additional sanctions up to and including dismissal from the university. In a case

where dismissal from the university is contemplated, the VPAA will consult with the faculty

member, student’s advisor, department chair, and college dean.

In cases in which the student contests the accusations of academic dishonesty, the student

may file a grievance under the undergraduate or graduate grievance procedure, whichever

one is applicable.

Ways to Avoid Involvement in Cheating:

1.Do not lend your work to anyone. If you wish to help a friend, go over the work togeth-

er and do not leave any copies in her/his possession.

2. Do not leave your work in any public place. Put your papers in an envelope and leave

them in the faculty member’s mailbox. Give them to the department secretary if you

cannot locate your faculty member.

3. When using campus computers, disguise file names or keep files only on personal

drives. Be aware that print commands will result in printed copies, even hours later.

Be sure to pick up all printed copies of your work, or delete any extra print com-

mands when you are finished.

Ways to Avoid Plagiarism:

1. Acknowledge any ideas, facts, or language taken from a source. Use citations appro-

priately and include a reference list (see the most recent editions of the Publication

Manual of the American Psychological Association or American Medical Association

Manual of Style for specific information).

2. Quote—any language taken from your original source, even key words or short

phrases, must be within quotation marks and quoted accurately. Reorganizing a sen-

tence, substituting a synonym, or altering a word or two does not make it your own

work!

3. Paraphrase—this means summarizing the source in your own words. Remember: par-

aphrased ideas must still be acknowledged. To paraphrase well, you must read care-

fully enough to digest ideas and make them your own.

37

“A final note on plagiarism: When you put your name on academic work and submit it,

you are claiming ownership of the work. If through carelessness or design you've blurred the

lines between what's yours and what you've taken from others, you are stealing intellectual prop-

erty. Don't do it. Plagiarism is risky and counterproductive. It harms your intellectual and moral

development. It leaves a permanent paper trail that can have devastating consequences, even

years down the line. And, most of all, it’s wrong” (Harvey, 2002)

All forms of dishonesty, whether by act or omission, including, but not limited to, cheating, pla-

giarism, and knowingly furnishing false information to the University, are prohibited. Intentional

disruption or obstruction of teaching, research, or administrative proceedings is prohibited. Uni-

versity sanctions may extend to suspension and dismissal.

Work submitted in courses must be the product of the efforts of the student presenting it, and

contributions of others to the finished work must be appropriately acknowledged. The presenta-

tion of another’s work as one’s own is a serious violation of the academic process, and it is pe-

nalized accordingly. The decision on the appropriate penalty is in the first instance the profes-

sor’s, and it may extend to a failing grade for the course.

Physician assistant students are expected to comply with the University’s academic integrity pol-

icies. In addition, physician assistant students must know and comply with the academic integri-

ty policy of the Master of Science in Physician Assistant Studies program which includes, but is

not limited to, the following:

• Students are not permitted to use notes or other materials during examinations unless express-

ly authorized in advance to do so by the instructor.

• Students are required to do their own work and, without prior approval of the instructor, may

not submit work created by others (including such things as papers purchased from commer-

cial enterprises) as their own work.

• Students are required to sit for examinations that are submitted to fulfill their own academic

obligations; students may not have another student or person take an examination for them.

• The same academic work may not be submitted more than once for credit or to fulfill the

requirements of an academic exercise.

• Obtaining a copy of an examination or graded assignment (e.g., case presentation, patient

education project) used in a previous year or completed by another person is prohibited.

• Prior to taking an examination or completing an assignment, students are not permitted to

review prior related examination questions or answers and/or graded assignments completed

by another person.

• Any student may not knowingly allow another student to copy or use his or her work.

38

• Student must give proper attribution when using the words or ideas of another person,

whether in a written or oral academic exercise. This includes, among other things, proper ci-

tation of quoted and paraphrased material.

• Knowingly presenting false information to program faculty and staff, supervisors, patients,

and clinical preceptors is prohibited.

• Falsifying any information including, but not limited to, laboratory data and patient infor-

mation is prohibited.

• Falsifying any document is prohibited.

• Forging another’s name or signature is prohibited.

• Misrepresenting oneself as a graduate of the program or of one’s physician assistant student

status as, for example, a physician assistant, nurse practitioner, medical resident, and the like,

is prohibited.

Breaches of integrity are regarded as very serious offenses and will be carefully considered on a

case-by-case basis.

Any breach of integrity may serve as grounds for dismissal, even on a first of-

fense.

Breaches in integrity will be reported to licensing agencies as required by law.

ACADEMIC SERVICES

Misericordia University has a wide variety of academic resources available to students. This sec-

tion highlights some of the resources most likely to be of value to you.

STANDARD A1.05 The sponsoring institution must provide academic and student health services

to PA students that are equivalent to those services provided other comparable students of the

institution.

ACADEMIC TUTORING

Early Alert

The Early Alert Program is a referral process used to enhance the retention of students at Miseri-

cordia University. Faculty, staff, or parents who are concerned about a student submit referrals

to the Retention Specialist for intervention assessments. After the initial assessment, the student

will be directed to the appropriate services (i.e., academic support, tutoring, personal counseling,

Insalaco Center for Career Development, Writing Center, minority mentoring, etc.).

39 Student Success Center

The Student Success Center (SSC) offers services to students who wish to improve the quality of

their learning. The center offers comprehensive support services through the following programs:

peer and professional tutoring, study skill support, ESL support, writing support, and workshops.

Individual assessment and intervention services regarding study skills and learning strategies are

also offered, as well as developmental intervention programs for students on academic probation

or for those who are not satisfied with their level of performance. The SSC is located in the

lower level of Alumnae Hall. All services are free of charge.

Tutorial Assistance

Misericordia University offers a variety of tutorial options to assist students in achieving aca-

demic goals. Individual and group tutoring is provided in most core curriculum courses and some

professional courses. Professional staff is available to assist those students who wish to improve

their study skills. Tutorial services are provided by the Student Success Center which is located

in the lower level of Alumnae Hall. All tutorial services are free of charge.

CAREER CENTER

Insalaco Center for Career Development

Preparing for a successful future demands more than just obtaining a quality education. Truly

successful students begin to develop career planning competency as first-year students and build

upon this throughout their academic and professional lives.

The Insalaco Center for Career Development provides the resources and assistance necessary to

turn academic achievement into career opportunity. Recognizing that the world of work requires

life-long learning, the Insalaco Center promotes the development of short-range goals as part of

long-range career plans. This approach helps ensure that students build flexibility into their ca-

reer plans. The Center serves all University students and alumni with its state-of-the-art career

resource library and team of professional staff. The mission of the Center is to prepare students

for employment, graduate school or professional school, and to manage their careers throughout

their working lives.

COMPUTER LABORATORIES

The University has 126 computer workstations or units available for student use. Computer la-

boratories are located in the following facilities:

Mercy Hall 349 (21 workstations)

Mercy Hall 335 (16 workstations)

Insalaco Hall (16 workstations)

Hafey-McCormick Science Building 205 (15 workstations)

Mary Kintz Bevevino Library Computer Laboratory (25 workstations)

Mary Kintz Bevevino Library, general use (10 workstations)

Mary Kintz Bevevino Library, laptop lending (30 workstations)

Passan Hall [formerly the College of Health Sciences Building] (3 workstations)

40 DISABILITY SERVICES

Office for Students with Disabilities

In accordance with Section 504 of the Rehabilitation Act of 1973 and the Americans with Disa-

bilities Act (ADA) of 1990, students with documented disabilities may seek academic accom-

modations for their disability free of charge. These academic accommodations include extended

time on tests, use of a note sharer, and tape recording of lectures.

Alternative Learners Project

The Alternative Learners Project (ALP) is a fee-based program of services offered in addition to

the services Misericordia University is required to provide students with disabilities under 504.

ALP services include an eight-week course in Learning Strategies and an individualized Program

of Accommodations (POA). The POA may include writing support instruction, access to a dedi-

cated study room, and time management skills. Each student meets individually with a Program

Coordinator on a weekly basis.

FINANCIAL AID

Student Financial Services

Administrative Regulation and Payment of Tuition and Fees

Misericordia University students are expected to pay their bills in a timely manner.

The Office of Student Financial Services assists students in meeting their obligations and will

discuss reasonable payment schedules in extraordinary cases. In order to assure the collection of

money due to the University, students with an unpaid balance for tuition, fees, bookstore charg-

es, library fines, parking fines or any other Misericordia University approved fee or fine will be

denied the following privileges or services:

Class registration

Participation in graduation ceremonies and the awarding of diplomas; also, seniors may be

denied final examinations

Transcript issue

Residence hall reservation privileges

Definition of Academic Year

Misericordia University defines its academic year as the period of at least 30 weeks of instruc-

tional time which begins on the first day of classes in the fall semester and ends on the last day of

examinations in the spring semester. The MSPAS program does not align with the undergraduate

catalog. During the didactic year students’ classes will extend throughout the entire summer

term. During the clinical year the students will not be on the same timeframe as the university

defined calendar. This is necessary to ensure that students receive sufficient clinical training dur-

ing the program. In addition this more rigorous schedule will prepare the students for actual pro-

fessional roles as physician assistants.

41 The Student Financial Services staff is available from 8:30am to 4:30pm to discuss individual

problems and to advise students in matters regarding financial aid.

Institutional Refund Procedure Relating to Withdrawals

When a student withdraws, he or she must begin the withdrawal process with the Retention Spe-

cialist located in the Student Success Center. The percentage of refund is determined by the date

the withdrawal process is completed by the student (see Withdrawal from University). Please

refer to the University Catalog for a complete description of the refund policies of the University.

UNIVERSITY LIBRARY

The Mary Kintz Bevevino Library, named in honor of an alumna who graduated in the class of

1987, is located at the heart of the campus between Mercy Hall and the McHale and Gildea Res-

idence Halls.

The library’s mission is to provide quality services with diverse resources for intellectual growth

and development. Library staff members are always available and ready to assist students with

all their research needs consistent with the Misericordia objectives of providing quality academ-

ics, professional preparation, and service leadership. Whether patrons are seeking research assis-

tance, available computer workstations, group study areas, or just a quiet place to read and re-

flect, the library facilities are designed to meet your needs.

STUDENT HEALTH

As you progress through your education, it is important that you pay attention to your own

health. A career in medicine is stressful, and medical providers are frequently guilty of setting a

poor example for their patients. Proper nutrition, exercise and stress coping skills will contribute

to your success as a student.

STANDARD A1.05 The sponsoring institution must provide academic and student health services

to PA students that are equivalent to those services provided other comparable students of the

institution.

STANDARD A3.09 Principal faculty, the Program Director, and the Medical Director must not

participate as health care providers for students in the program.

STUDENT HEALTH SERVICES

Student Health Center

The Student Health Center, located on the lower level of the Anderson Sports/Health Center, is

directed by a registered nurse with a master’s degree. A nurse practitioner and a part-time regis-

tered nurse are also on staff and function under the guidance of the university’s medical physi-

cian. Health care providers have regularly scheduled clinic hours on campus. Health care provid-

ers are also available by telephone for advice and referrals during the week. The Health Center is

open Monday through Friday, 9:00 a.m. to 5:00 p.m. If medical services for resident students are

needed after hours, the student should contact their respective resident advisor (RA) who will, if

necessary, inform the Director of the Health Center of the issue. The program’s principal faculty,

the Program Director, and the Medical Director will not participate as health care providers for

students in the program.

42 MENTAL HEALTH AND COUNSELING

STANDARD A3.10 The program must have written policies that provide for timely access

and/or referral of students to services addressing personal issues which may impact their pro-

gress in the PA program.

Counseling Center

The services offered by the Counseling Center are available to all full and part-time undergradu-

ate and graduate students. Services include individual counseling, group counseling, consultation

services, referral services, and crisis intervention.

Misericordia also offers programs on a variety of personal development topics and issues

throughout the academic year. All services are free of charge and all counseling contacts are con-

fidential. Records of counseling contacts are kept separate from a student’s medical or academic

records.

HEALTH INSURANCE

Insurance is required for all students. Students not covered by their parents' insurance are eligible

to purchase a student group health insurance selected by the University. Student insurance forms

are available in the Office of the Dean of Students.

All resident students and students in athletic programs must carry health insurance. If a student is

covered by their parent's plan, a Xeroxed copy of the insurance card must be provided to the

Health Center and updated on a yearly basis.

HEALTH AND IMMUNIZATION DOCUMENTATION

STANDARD A3.21 Student health records are confidential and must not be accessible to, or re-

viewed by, program, principal or instructional faculty, or staff except for immunization and tu-

berculosis screening results which may be maintained and released with written permission from

the student.

STANDARD A3.07 The program must have and implement a policy on immunization of students,

and such policy must be based on current Centers for Disease Control recommendations for

health professionals.

Student Health Records and Immunizations

In order to meet the accreditation standards of the ARC-PA for the Master of Science in Physi-

cian Assistant Studies degree at Misericordia University, the University has contracted with

CERTIPHI to store, monitor, and maintain confidential student health records. CERTIPHI is a

confidential student health record service. CERTIPHI will mail all students the health forms that

are required and must be filled out. Upon receipt of your health forms, CERTIPHI will provide

the student with a membership card which will enable the student to have all the necessary con-

tact information as well as their CERTIPHI account number.

43 Additionally, each student will receive a letter from CERTIPHI indicating compliance with Uni-

versity requirements. It is imperative that the student complete all required health records and

immunizations forms prior to matriculation in August. Failure to provide complete health records

may delay entry or the ability to participate in required clinical rotations.

In addition to storing student health information, CERTIPHI will keep the director of clinical

education at Misericordia University up-to-date with the status of all student immunizations.

Student health records will not be released without written permission from the student. Health

screening, immunizations, and/or healthcare services will not be conducted by program person-

nel.

Health packages include:

Student Health History and Information form

Physical Examination form

Immunization Verification From

Specific health screening and immunization requirements are based on current Centers for

Disease Control Recommendations for health professionals.

Requirements include:

1. Proof of personal health insurance throughout the entire program

2. Proof of a satisfactory physical examination

3. Proof of TB tine test (positive results will require the student to receive a chest x-ray and fur-

ther evaluation)

4. Proof of Hepatitis B vaccine and positive Hepatitis B Antibody test

5. Proof of MMR vaccine or immunity

6. Proof of Varicella history or vaccination

7. Proof of tetanus/diphtheria/pertussis vaccine

8. Proof of pneumococcal polysaccharide PPV vaccine

9. Satisfactory drug screen

Prior to entering the clinical phase of the program, students must again update their immuniza-

tion record and provide proof of the following:

1. Proof of current CPR certification

2. Proof of updated annual TB PPD or tine test

3. Proof of blood-borne pathogen orientation course

4. Proof of current personal health insurance, throughout the clinical year

5. Satisfactory Level One criminal background

6. Satisfactory physical examination

7. Satisfactory drug screen

Note: Health screening and student immunizations may not be conducted by faculty or staff of

Misericordia University.

Misericordia University student health records are confidential and will not be maintained by, or

accessible to, the physician assistant program faculty or staff except for immunizations and

tuberculosis screening results.

44 Student health records will not be released without written permission from the student. Health

screening, immunizations, and/or healthcare services will not be conducted by program

personnel.

INJURIES & NEEDLE STICK/BLOOD/BODILY FLUIDS CONTAMINATION

PROTOCOL

STANDARD A3.08 The program must inform students of written policies addressing student ex-

posure to infectious and environmental hazards before students undertake any educational activ-

ities that would place them at risk.

Accidents will occasionally occur in the laboratory or in the clinical setting. If a student is in-

jured in a laboratory or classroom setting, the instructor should be notified immediately. If a stu-

dent is injured at a clinical site, the clinical preceptor should be notified immediately and the stu-

dent must follow that site’s protocol for dealing with injuries. In many facilities, this will require

students to seek treatment in the employee health department, the occupational medicine depart-

ment, or the emergency department. If the clinical site lacks these resources, treatment should be

sought in the nearest emergency department.

Exposure to blood borne pathogens is a risk assumed by all healthcare providers. Students will

receive training to minimize their risk during orientation. Individual clinical sites may also pro-

vide orientation sessions regarding blood borne pathogens. Observing universal precautions is

one method to reduce risk.

The principle of universal precautions recognizes that any patient may be infected with microor-

ganisms that could be transmitted to other persons. Of particular concern are the primarily

blood-borne pathogens HIV (human immunodeficiency virus) and HBV (hepatitis B virus).

However, body fluids other than blood, secretions, and excretions are included in universal pre-

cautions. Since infected patients may be asymptomatic, it becomes necessary to use basic pre-

cautions with every patient. Observance of universal precautions will help to provide better pro-

tection for every staff member. Students should also familiarize themselves with the hospi-

tal/clinical sites’ specific policies regarding universal precautions.

Universal Precautions Guidelines:

Act as though all patients you have contact with have a potentially contagious blood borne

disease

Avoid direct contact with blood, body fluids, secretions, excretions, mucous membranes,

non-intact skin, and lesions

Avoid injuries from all “sharps”

Avoid direct contact with items, objects, and surfaces contaminated with blood, body fluids,

secretions, and excretions

Dispose of all “sharps” promptly in special puncture resistant containers

Dispose of all contaminated articles and materials in a safe manner prescribed by law

45

In practice, using Universal Precautions also requires:

Washing hands frequently and thoroughly, especially if they become contaminated with

blood, body fluids, secretions, and excretions.

Depending on job duties and risk of exposure, using appropriate barriers, including gloves,

gowns, aprons, caps, shoe covers, leggings, masks, goggles, face shields, and equipment such

as resuscitation devices.

These barriers are to be used to protect:

A. Skin, especially non-intact skin (where there are cuts, chapping, abrasions, or any

other break in the skin)

B. Mucous membranes, especially eyes, nose, and mouth

NOTE: These items of protective apparel, including gloves are removed after each use and

are properly disposed. The same pair of gloves, etc,. are NOT to be worn from one patient

or activity to another.

Students will wear protective equipment as directed by their clinical preceptor or facility

protocol

All patient specimens are bagged per facility protocol before transport to the laboratory

In the event a student is injured by a contaminated “sharp” or is exposed in any manner to blood

or potentially infectious bodily fluids in the course of their assigned clinical work, the following

steps should to be followed for proper treatment and follow-up for the student.

Upon possible exposure to a blood borne pathogen:

1. For skin and wounds, wash the affected area with soap and water. Eyes and mucous mem-

branes should be copiously flushed with water. Notify your clinical preceptor immediately.

2. Follow facility protocols regarding evaluation. Most facilities will require you to report im-

mediately to employee health or the emergency department following exposure. Failure to

follow up properly may make it difficult or impossible to obtain source patient blood in facil-

ities in cases in which this may be possible.

3. In sites without employee health or emergency departments, or if the site protocol is unclear,

proceed immediately to the nearest emergency department for assessment. In cases in which

prophylactic medical treatment is indicated, it is believed to be most effective when adminis-

tered as quickly as possible.

4. The treating healthcare professional will request information about your medical history, the

source patient’s history (if known) and the nature of the exposure. They may request permis-

sion to draw baseline laboratory studies. They will discuss your risk of contracting a blood

borne disease and the risks and benefits of prophylactic treatment. In deciding whether to re-

ceive post-exposure prophylactic treatment, students might also wish to consult with the Na-

tional Clinicians Post-Exposure Prophylaxis Hotline: 888-448-4911.

5. Students should follow up as directed by their treating healthcare provider. Ongoing follow-

up may take place at the initial treating facility or the student may be referred to a healthcare

provider with expertise in infectious disease. The program may be able to assist the student in

finding an infectious disease specialist as requested or required.

46 6. Since students are neither employees of Misericordia University nor the clinical sites, pay-

ment for assessment and treatment is the responsibility of the student and their insurance car-

rier.

All students who experience an injury or exposure must complete an incident report and submit

it to the Program Director as soon as possible. Students should not delay prompt evaluation and

treatment to complete paperwork.

ABSENCE, LEAVE AND WITHDRAWAL

ABSENCE – GENERAL

Physician assistant education is intensive. There is a mandatory attendance policy for all required

learning experiences throughout the program. We recognize that situations beyond your control

occasionally arise, but you should make every attempt to attend all scheduled sessions.

Students should exercise sound decision making skills when making decisions regarding missing

course lectures, assignments, examinations, or clinical rotations. Mild upper respiratory infec-

tions may not warrant missing course work or examinations. Weddings, family vacations, or ex-

pensive airline reservations may not be considered a valid excuse for missing an examination or

requesting an alternative examination date. Unexcused absences may result in a score of zero on

assignments and examinations. Make-up examinations may be offered at the discretion of the

course instructor on a case-by-case basis. Make-up examinations may be given in an alternate

format.

During the clinical year each student will be given a two week break during the Christmas and

New Year holidays as well as an allotment of 5 days to be used for absences of any kind. The

following rules apply to the use of these days:

Anticipated Absence

Students who know in advance that they will be absent due to events such as employment inter-

views and religious observances not provided for on the university calendar should clear the ab-

sence at least 30 days in advance. Time off must generally be made up within one week.

Anticipated Absence Action

First Professional Year Contact your faculty advisor at least 30 days in ad-

vance to discuss clearance.

Second Professional Year Contact the Director of Clinical Education and your

clinical preceptor at least 30 days in advance to

discuss clearance.

Unanticipated Absence

Occasionally, a student is unable to attend class or rotation due to an unexpected personal or

family emergency. Documentation of the event may be required by the Program.

47 Unanticipated Absence Action

First Professional Year Contact your faculty advisor or program secretary

as soon as possible.

Second Professional Year Contact the program secretary, the Director of Clin-

ical Education, and your clinical preceptor as soon

as possible.

ABSENCE FROM EXAMINATIONS

STANDARD C3.01 The program must conduct frequent, objective and documented evaluations

of students related to learning outcomes for both didactic and supervised clinical education

components.

Students are required to be present for examinations as scheduled. Students who are late for ex-

aminations forfeit the time allotted and will not be permitted to recover that examination time. In

the event of serious personal illness/injury or the death of an immediate family member, students

may be excused from course work or examinations as necessary. The program may require a

written statement from a licensed physician or health care provider explaining your illness or in-

jury. A copy of the immediate family member’s death certificate may be requested by the pro-

gram as proof of the student’s absence.

Under no circumstances will students be permitted to take an examination before the regu-

larly scheduled examination. In other words, there will be no “make-up” examination adminis-

tered prior to the official examination date and time.

ABSENCE FROM CLINICAL ROTATION

Attendance at clinical sites is an absolutely essential component of a student’s education.

Students must inform their clinical preceptors and the program when, for any reason, they will

not be at their clinical site. Students should contact the program secretary and the Director of

Clinical Education via phone or email; they will in turn inform the Program Director.

As graduation approaches, it is expected that students will need to schedule employment inter-

views. As with any other absence, these must be cleared with the clinical preceptor and faculty

advisor.

BEREAVEMENT

Absence from class or a rotation will be granted for the death of a first-degree relative or grand-

parent. The student will normally be allowed three (3) business days for in-state services and

four (4) days for out-of-state services. The faculty advisor and Program Director should be con-

sulted so that a study plan can be put in place to allow the student adequate time for make-up

work.

48 LEAVE OF ABSENCE

The university does not recognize leaves of absence from graduate academic programs.

SUSPENSION

Courses in the physician assistant curriculum are offered only once a year. If a student should

fail a course, it is necessary to wait until the course is offered again before the student can com-

plete it and advance in the program.

WITHDRAWAL

It is not unusual for students to experience stress in adjusting to the rigors of physician assistant

education. Students considering a withdrawal from the program should consult with their faculty

advisor and/or the Program Director before initiating the withdrawal process.

A student may withdraw from the program by written request to the Program Director. It may be

possible for a student who is withdrawing from the program to maintain matriculation at Miseri-

cordia University. Students should consult with their faculty advisor and the university catalogue

for further information.

PROCEDURE FOR READMISSION

Following Suspension

Students, who have been suspended from the program for any reason, including violation of pro-

fessionalism or academic policy, must apply in writing for readmission to the Program Director

prior to the fall semester of the next academic year. Students may be required to audit courses,

repeat coursework, or pass written and/or practical examinations to demonstrate competence be-

fore returning to the program.

Following Dismissal

Students, who have been dismissed from the program for failing a course or any other reason,

may not return to the program at any time.

COMMUNICATION

CELLULAR PHONES

Out of respect for your classmates and lecturers, please turn your cellular telephone off prior to

class.

EMAILS

While enrolled as a student in the program, the email address of record shall be the E-MU

email address assigned upon admission to the program. It is strongly encouraged that students

check their E-MU email account as well as any Blackboard course announcements at least once

every 24 hours.

49 EMERGENCY PHONE CALLS

Please inform friends and family that they should contact the program secretary if an emergency

should arise while class is in session. A message will be delivered to the student, as cellular tel-

ephones must be switched off while in class. Please contact Mrs. Kathy Michael at

570.674.6716 or Helen Bogdon at 570.674.6378.

STUDENT REPRESENTATION

Each class may elect a class representative who will bring issues that affect the entire class to the

attention of the Program Director.

The Physician Assistant Student Society of Misericordia University (PASSMU) will represent

the entire student body of the PA Program. PASSMHU will elect officers and hold class

meetings as needed to determine the consensus of the entire student body regarding any issues

affecting the entire class. A faculty advisor will be assigned to PASSMU to aid in the use of

resources and will coordinate activities of the student body within the Student Academy of the

American Academy of Physician Assistants (SAAAPA).

DIRECTOR’S HOUR

Every semester the Program Director will meet with each class as a whole to discuss any out-

standing issues and to answer any questions. Students may request a director’s hour at any time

via the class representative. For issues affecting individual students, however, students are en-

couraged to make individual appointments with the Program Director at any time.

MISCELLANEOUS POLICIES

EMPLOYMENT DURING THE PROGRAM

In order to enhance student learning and assure student success in the physician assistant pro-

gram, it is recommended that students minimize the hours worked outside of the program. If a

student chooses to work during the academic year, the work schedule must not interfere with

class performance or clinical rotation schedules.

EXAMINATION SECURITY

To maintain security during examinations, examination proctors reserve the right to inspect any-

thing a student brings with them into an examination room.

HOLIDAYS

During the first year of the program, students will observe the usual academic calendar issued by

the university.

While on rotation during the second year of the program, students will experience an irregular

schedule. No student should make travel arrangements without consulting with his/her faculty

advisor, the Director of Clinical Education, and his/her clinical preceptor.

50

Students are not required to attend their rotations on holidays designated at the discretion of the

clinical sites. Students may request time off for bona fide religious observances, but patient

needs take priority, and there is no guarantee that such requests will be honored by a clinical site.

WEATHER-RELATED EMERGENCIES

In the event of severe weather, students should check with the MU webpage or call the universi-

ty. Students are expected to use their best judgment in deciding to travel. Students on rotation

sites not affected by the adverse weather conditions are required to attend their rotation even if

the University is closed. Conversely, students at a clinical site with significant adverse weather

conditions must use their best judgment in consultation with their preceptors in determining their

attendance at the site regardless of the University’s status. Students must notify the program of

non-attendance as noted above.

51

PART II: POLICIES, PROCEDURES AND

OBJECTIVES RELATED TO CLINICAL

ROTATIONS

CLINICAL ROTATIONS & AFFILIATION

AGREEMENTS

STANDARD A1.02 There must be written and signed agreements between the PA program

and/or sponsoring institution and the clinical affiliates used for supervised clinical practice ex-

periences that define the responsibilities of each party related to the educational program for

students.

STANDARDS A3.03 Students must not be required to provide or solicit clinical sites or precep-

tors. The program must coordinate clinical sites and preceptors for program required rotations.

Most physician assistant students eagerly look forward to beginning clinical rotations. Each clin-

ical environment holds different challenges and different rewards and serves as the starting point

in your transition from student to clinician.

Misericordia University has affiliation agreements in place with physicians and healthcare insti-

tutions allowing for a complete course of clinical rotations to be set up for each student by the

52 program. In general, rotations are assigned randomly based upon their availability. Students will

be afforded the opportunity to select an elective rotation, and it is also occasionally possible for a

student to set up a rotation outside of the program’s presently-established clinical sites. More

information on these situations may be found below.

CORE ROTATIONS

STANDARD B3.02 Supervised clinical practice experiences must enable students to meet pro-

gram expectations and acquire the competencies needed for clinical PA practice.

STANDARD B3.03 Supervised clinical practice experiences must provide sufficient patient expo-

sure to allow each student to meet program-defined requirements with patients seeking: medical

care across the life span to include, infants, children, adolescents, adults, and the elderly, wom-

en’s health (to include prenatal and gynecologic care), care for conditions requiring surgical

management, including preoperative, intra-operative, and postoperative care, and care for be-

havioral and mental health conditions.

STANDARD B3.04 Supervised clinical practice experiences must occur in the following settings:

outpatient, emergency department, inpatient, and operating room.

STANDARD B3.07 Supervised clinical practice experiences should occur with preceptors prac-

ticing in the following disciplines: family medicine, internal medicine, general surgery, pediat-

rics, ob/gyn, and behavioral and mental health care.

Curriculum Outline - Year II

Professional Year II clinical rotations include rotations in:

PA 601 Ambulatory Medicine 5 weeks 5 credits

PA 603 Internal Medicine 5 weeks 5 credits

PA 604 Pediatrics 5 weeks 5 credits

PA 605 Psychiatry 5 weeks 5 credits

PA 606 Surgery 5 weeks 5 credits

PA 607 Women’s Health 5 weeks 5 credits

PA 608 Emergency Medicine 5 weeks 5 credits

PA 609 General Elective Rotation 5 weeks 5 credits

PA 609 General Elective Rotation 5 weeks 5 credits

PA 610 Research Rotation 4 weeks 0 credits

Clinical Clerkships 45 credits

PA 631 Professional Development 1 credit

PA 632 PANCE Preparation 2 credits

PA 633 Summative Evaluation 1 credit

Total 49 credits

53 ELECTIVE ROTATIONS

Students will have the opportunity to select two elective rotations from several specialties. The

specialties available may vary from year to year depending upon site availability. Any interna-

tional rotation will count as an elective. Students will be afforded the opportunity to indicate in-

terest in an elective rotation at the end of the second professional year. Students who fail a core

rotation will usually lose the opportunity to take an elective rotation as this time will be used to

remediate the failed rotation.

STUDENT-INITIATED ROTATIONS

Students may seek to develop a new rotation site. There are a variety of reasons for doing so.

Some students may wish to rotate through a specialty that is not currently available through the

program; others may desire to rotate close to home to establish contacts for employment. The

program is happy to attempt to accommodate these requests. However, students should recognize

that when possible, it may often take months to set up such rotations. Please observe the follow-

ing:

Students should allow at least six months for the necessary paperwork to be completed.

The student is responsible for identifying the site and making initial contact with the physi-

cian/preceptor. If the physician/preceptor agrees to accept a student, the student will forward

the physician’s/preceptor’s contact information to the Director of Clinical Education.

The Director of Clinical Education will investigate the site to determine if it is an appropriate

placement. A student may not have a relative serve as their preceptor.

MEDICAL MISSIONS

At this time the MSPAS program does offer international rotations/experiences in Belize. Stu-

dents may also have the opportunity to participate in short (7-10 days) international medical mis-

sions. Such experiences are best scheduled over breaks. In keeping with the program’s mission

statement, which specifies that “The program’s educational environment will promote an ethos

of service, responsibility, morals and ethics,” the program will be seeking to develop internation-

al clerkships in the future.

ROTATION-SPECIFIC POLICIES

ASSIGNMENTS

In addition to assignments required by the program, some rotation sites may have specific as-

signments that they require of students rotating with them. Such assignments may include (but

are not limited to) papers, examinations, presentations, or attendance at lectures. Students should

regard these assignments as requirements for successful completion of the rotation.

54 CHARTING

Some rotations may allow a student to record information into the medical record. It should be

remembered that such entries into the chart serve as a permanent part of the patient’s legal medi-

cal record. Any time a student makes an entry into the chart, it will be signed by the student. The

student will indicate that they are a physician assistant student by writing “PA-S” following his

or her signature. Students must ensure that their chart entries are countersigned by their preceptor

as soon as possible or as required by facility policy.

Learning to document properly is an essential medical skill. On rotations where students are not

permitted to record information in the chart, they are encouraged to practice documentation sepa-

rately and have it reviewed by their preceptor or faculty advisor.

CONFIDENTIALITY

As noted previously, all patient information must be held in strict confidence. The sharing of

medical information is to be limited to that needed for patient care or legitimate medical educa-

tion purposes. An intentional breach of patient confidentiality will be regarded as a serious of-

fense.

HOLIDAYS

Students are not required to attend their rotations on holidays designated at the discretion of the

clinical site. Students may request time off to meet other religious obligations. Such requests

should be cleared by both the clinical preceptor and the faculty advisor. Holidays can be difficult

times for staffing a healthcare institution. Please be as flexible as possible.

IDENTIFICATION

In addition to displaying an appropriate identification badge prominently, students shall state

truthfully and accurately their professional status in all transactions with patients, health profes-

sionals, and other individuals for whom, or to whom, they are responsible. While in the program,

students may not use previously earned titles (i.e., RN, MD, DC, Ph.D.). Students will sign all

documentation with their full name followed by “PA-S.”

INTERVIEWS

As graduation approaches, it is expected that students will need time to interview for employ-

ment. Requests for time off for interviews should be cleared with the Director of Clinical Educa-

tion, the clinical preceptor, and the faculty advisor.

PATIENT SAFETY

A student’s primary concern should be the health and safety of the patient. Students are expected

to exercise good judgment and immediately notify their preceptor of any circumstances which

may lead to patient harm. The student shall have ongoing consultation with the supervising phy-

sician as required to safeguard and enhance the care of the patient and to ensure the development

of clinical skills. Students will perform only procedures authorized by the preceptor, and all pro-

55 cedures should be performed under the supervision of a preceptor until the student and preceptor

are comfortable that the student is proficient.

ROTATION SCHEDULE

While on rotation, physician assistant students function as part of a healthcare team. As such, it

is frequently necessary to put the needs of the team ahead of personal interest. Your schedule

will vary widely among specialties and clinical sites. On some rotations students may be required

to take overnight call or cover weekend or overnight shifts. Sites will appreciate flexibility on

your behalf, and some of the best learning opportunities occur “after hours.”

STUDENT SCOPE OF PRACTICE

STANDARD A3.06 Students must not substitute for clinical or administrative staff during supervised

clinical practical experiences.

The student is not considered an employee of any clinical affiliate and should not be a substitute

for, or take on any responsibilities of, regular staff. If a student has a concern about the respon-

sibilities assigned by the clinical site, the Director of Clinical Education should be contacted

immediately.

The following are some guidelines regarding what a PA student may be permitted to do by the

preceptor. Please note that these are guidelines only. The judgment of the preceptor regarding

how much responsibility a student is ready to assume should be the guideline for determining

which tasks are assigned and how much supervision is needed.

Students come to our program with a variety of life experiences, which may affect their comfort

level with certain tasks. All students should exhibit a baseline of medical knowledge and clinical

skills. Typical tasks assigned to PA students include:

1. Taking histories and performing physical examinations;

2. Assessing common medical problems and recommending appropriate management;

3. Performing and assisting in diagnostic and therapeutic procedures;

4. Assisting the preceptor in hospital/nursing home rounds, recording progress notes, transcribing

specific orders of the preceptor – as allowed by the facility;

5. Following protocols or standing orders of the preceptor.

6. Presenting patient cases orally and in a written problem-oriented format.

7. Discussing the basic pathophysiologic mechanisms that have produced the signs, symptoms, and

disease processes under investigation.

8. Completing assigned readings and preparing presentations as requested by clinical preceptors

and/or program faculty.

9. Attending all teaching rounds and conferences.

10. Following the assigned on-call schedule.

Students will deliver needed care to patients without regard to race, age, gender, creed, socioeco-

nomic status, political persuasion, sexual preference, or national origin.

56 SITE SPECIFIC POLICIES

Most rotation sites will have their own policies and procedures that cannot be described here.

Such policies may relate to orientation sessions, parking, identification, etc. If questions regard-

ing these policies arise, please consult with your clinical preceptor or Director of Clinical Educa-

tion.

TRAVEL TO CLINCIAL SITES

Students are responsible for arranging travel to all clinical sites and any associated fees (i.e.,

parking). Some sites may be reached by public transportation, but most students will require a

car for reliable transportation.

SITE VISITS

STANDARD C4.01 The program must define, maintain and document effective processes for the

initial and ongoing evaluation of all sites and preceptors used for supervised clinical practice

experiences to ensure that sites and preceptors meet program defined expectations for learning

outcomes and performance evaluation measures

STANDARD C4.02 The program must document that each clinical site provides the student ac-

cess to physical facilities, patient populations and supervision necessary to fulfill program ex-

pectations of the clinical experience.

A faculty member (usually the Director of Clinical Education) will be performing on-site visits.

The purpose of the site visit is two-fold. First, as per the ARC-PA standards, clinical sites must

be assessed continually to make sure that the site is student ready and is an appropriate and quali-

ty teaching environment. Second, site visits help faculty observe the progress of each student and

observe the interactions between student, patient, and preceptor.

During a site visit, a faculty member will meet with each student and discuss the overall rotation.

In an effort to improve presentation skills, students will usually be asked to present one or more

patients during a site visit. Students will be asked to be prepared to present a patient in any and

potentially all of these 3 formats:

Comprehensive: Complete HPI, PMH, FH, SocHx, ROS, PE, laboratory studies, assess-

ment, including differential diagnosis, and plan, not to exceed 7 minutes speaking at an un-

derstandable pace.

Detailed: Relevant features of all elements of presentation, but able to use terms such as

"non-contributory," "unremarkable" for categories. Acceptable to say that laboratory studies

are normal and PE is normal except for [specified condition]. The intention is to highlight

pertinent positives and negatives, but not specifically to mention irrelevant information. The

presentation should not exceed 3 minutes.

Brief: HPI and PMH should be limited to one sentence; physical examination and laborato-

ry studies should be limited to one sentence; and differential diagnosis, assessment, and plan

should be limited to one sentence. The presentation should not exceed 30 seconds, and it

should not total more than 6 sentences.

57 The purpose of this exercise is to provide a student with individual feedback in a safe, protected

environment that will improve communication skills.

During the site visit, the faculty member may ask to observe the student interacting with a patient

including obtaining a medical history, performing an appropriate physical examination, collect-

ing pertinent data specific to the case, and presenting the case to the clinical preceptor. The facul-

ty member may also ask to inspect any documentation recorded by the student.

Site visits for all rotations may be arranged randomly at the discretion of the program. Site visits

may occur during any rotation and may be unannounced. A Site Visit Evaluation form (see

Appendix I) or an online equivalent will be completed by faculty after each site visit and will be

placed in the student’s file.

ACADEMIC REQUIREMENTS FOR CLINICAL

COURSES

E*VALUE

The MSPAS program uses an Internet-based system to assist with collecting documentation. The

system is called E*Value. Orientation regarding the operation of this system will be provided to

students prior to beginning clinical rotations.

CLINICAL LOGS

Clinical logs are designed to help the program track your experiences through your clinical rota-

tions. Filling out logs thoroughly and accurately will help us to ensure that you are receiving a

quality clinical education. Documentation for diagnoses seen and procedures performed will be

submitted through the E*Value system.

WRITTEN ASSIGNMENTS

For each clinical rotation, students will submit one written assignment. Most commonly, students

will be assigned to complete and document an appropriate history and physical examination

(H&P) (see Appendix J) for a patient under their care. With the approval of the student’s faculty

advisor, an alternate assignment such as a topic paper may be substituted for the H&P.

History and Physical Examination Write-Up

On most rotations, students will complete a handwritten history and physical examination write-

up. Written H&P requirements may be altered by a faculty advisor, depending upon the quality

of previous work. The written H&P must be submitted prior to completing the post-rotation ex-

amination.

Grading of Written History and Physical Examination Write Ups

Learning proper medical documentation is an essential skill. Building upon the knowledge

gained during the first year of the program, students will record an appropriate history and physi-

58 cal examination (H&P) for each rotation unless other arrangements are made with their faculty

advisor.

All H&Ps submitted for grading from all rotations must be complete, consisting of the following

parts:

Chief Complaint

History of Present Illness

Past Medical History

Social History (as relevant)

Family History (as relevant)

Review of Systems (as relevant)

Physical Examination Findings

Diagnosis Study Findings (as indicated)

Assessment/Differential Diagnosis

Plan

H&Ps written during inpatient experiences should be comprehensive. A student’s faculty advisor

may require that a student submit additional documentation, including but not limited to admis-

sion notes, admission orders, progress notes, procedure notes, discharge orders, and a discharge

summary.

H&Ps written during outpatient experiences will generally be more problem-focused, depending

upon the nature of the patient’s condition. For further information, please consult with your fac-

ulty advisor regarding expectations.

Grading of H&Ps will be performed according to a rubric established by the program and pub-

lished as the Clinical Rotation Written History and Physical Examination form (see Appendix J).

Unless previous arrangements are made with a faculty advisor, late submission will result in

grade reduction by one letter grade.

Topic Papers

For specialty rotations with no End of Rotation Evaluation (EORE), students may submit a 4 to 5

page topic paper to their faculty advisor in place of a written H&P on or before the last day of the

rotation. The topic for this paper must be approved by the faculty advisor and conform to Ameri-

can Medical Association Manual of Style guidelines. Additionally, the paper must have a mini-

mum of three major source references published within the past five years.

Grading of topic papers will be performed according to a rubric established by the program and

published as the Evaluation of Topic Paper form (see Appendix K). Unless previous arrange-

ments are made with a faculty advisor, late submission will result in grade reduction by one letter

grade.

MID-ROTATION PRECEPTOR EVALUATION

Mid-rotation evaluations (see Appendix L) are designed to give the preceptor an opportunity to

provide feedback to students on their performance during each clinical rotation. Students should

take this information and opportunity to strengthen their skills. A portion of the mid-rotation

evaluation is designed for you to self-reflect on your clinical experience and to identify areas of

improvement as well as strengths. Students must complete this portion of the evaluation before

submission.

59

One mid-rotation evaluation must be submitted to the program for each rotation. This evaluation

must be submitted to the program midway through the rotation. If a mid-rotation evaluation is

not submitted, you receive an incomplete final grade for the course.

The mid-rotation evaluation helps to avoid surprises related to your grade at the end of the se-

mester. If any academic or clinically related problems arise from this interaction that is of con-

cern, it is in the students’ best interest to discuss this with their faculty advisor. Your signature

indicates your review of the evaluation: do not sign the mid-clerkship evaluation and then hand it

to your preceptor to be filled out. Only the assigned preceptor should fill out the evaluation.

END-OF-ROTATION PRECEPTOR EVALUATION

The program has adopted a standard grading rubric for clinical preceptors. Grading may be

completed online through the E*Value system, or clinical preceptors may choose to submit a

paper evaluation (see Appendix M). Students will be evaluated by each clinical preceptor on the

basis of their general medical background, knowledge, and ability to obtain a medical history and

perform an appropriate physical examination. Included in the evaluation will be the student’s

ability to organize a database, propose a management plan, present cases, and demonstrate

rapport with patients and co-workers. Dependability, attitude toward learning, and work habits

are also part of the evaluation.

Students are encouraged to discuss the evaluations with their preceptors. Students are responsi-

ble for ensuring that an evaluation is completed for each clinical rotation. They must make every

reasonable effort to follow-up with the site to ensure that the evaluation is completed in a timely

fashion. Some sites choose to mail their evaluations to the Program. In this case students should

check with their faculty advisor to ensure that the form has been received. Failure to receive

evaluations in a timely fashion may result in a student receiving a grade of “incomplete” (I)

In some instances a resident or another attending physician may complete a preceptor evaluation

form in addition to the clinical preceptor of record. In those cases a maximum of two evalua-

tions will be averaged to comprise this portion of the rotation grade.

POST-ROTATION EXAMINATIONS

An End of Rotation Examination (EORE) is given after each core rotation and is based on a spe-

cific reading list for that rotation.

The program attempts to emulate the national certifying examination by using the NCCPA Con-

tent Blueprint as a guide for reading topics. Also like the national certifying examination. The

Program reserves the right to re-administer an examination at a later date if technical difficulties

occur on the scheduled examination date.

The majority of EOREs are given on call-back days or the Friday of the last week of the sched-

uled rotation.

STUDENT EVALUATION OF CLINICAL SITE

The student evaluation is designed to provide the program with student feedback regarding each

clinical site. It is used to evaluate and improve the site and in turn the student’s clinical experi-

ence. This process is important for continued quality control and feedback. A student’s rotation

grade will not be released until he or she has completed an evaluation of the clinical site. Evalua-

60

tions of clinical sites will be completed online using the E*Value system (for a sample of this

evaluation form, see Appendix N).

SEMINAR

All students in the clinical phase of the program are required to attend regularly scheduled semi-

nars. These seminars are integral to the clinical phase of the MSPAS Program, and are generally

used to prepare for the Physician Assistant National Certifying Examination (PANCE). Attend-

ance is mandatory. Specific information relating to the seminar schedule will be sent to the stu-

dents by the faculty member facilitating the seminar. The student will be required to complete

the following study system:

HIGH IMPACT NOTE SYSTEM

This learning and evaluation method is a very effective vehicle for students to prepare for in-

class discussions and maximize learning styles. By completing the assigned high-impact notes in

the Classroom to Clinic system, the student will be using multiple learning methods, such as

reading, writing, kinesthetic, and connecting the knowledge with in-class clinical discussions.

The instructor will be providing orientation about how to utilize this learning system in the

course.

INSTRUCTIONAL STRATEGIES:

Description: the current format in the Classroom to Clinic software involves the students writing

outlines in the software interface. To promote higher-level critical thinking the assignment will

involve applying each of the high-impact outlines into real-life clinical scenarios and construct-

ing questions. For each disease state in the NCCPA blueprint found in the CD-ROM the stu-

dents will demonstrate competency using the following strategies to synthesize and integrate the

information. This will enable the student to be able to apply the information and therefore more

effectively answer questions on the NCCPA exam that involve more advanced levels of analysis

synthesis and evaluation. This assignment uses Blooms taxonomy as a guideline.

Rationale for Pedagogical Method:

The Classroom to Clinic system of writing high impact notes was based upon the principle that

the student constructs his/her own personal meaning of the content. If used as the system was

designed then students would apply the information at higher levels of Blooms taxonomy .

Description: Students will still be required to complete assignments for each disease item on the

blueprint found in Classroom to Clinic. Using the clerkship study plan students will complete the

assignment below for each topic on the clerkship study list.

BLOOM'S TAXONOMY LEVEL - ANALYSIS

Students must separate material or concepts into component parts so that its organizational struc-

ture may be understood. Distinguishes between facts and inferences.

61

Assignment:

The student must synthesize and discriminate the most important key concepts for each disease

state. This involves writing, in one’s own words, a synopsis of the high-impact author note. This

must demonstrate the ability to extract the most important information and rewrite in the students

own words and interpretation. To demonstrate the achievement of the students ability to analyze

this information they must write a clinical vignette in their own words that incorporates the key

concepts for each disease state in the blueprint. The length of the vignette should be sufficient to

describe the disease with enough detail to clearly delineate key concepts.

BLOOM'S TAXONOMY LEVEL - SYNTHESIS:

Students must build a structure or pattern from diverse elements. Put parts together to form a

whole, with emphasis on creating a new meaning or structure.

Assignment:

Write two questions for each disease on the blueprint.

To achieve the level of synthesis the students will write two questions for each disease state.

These two questions will include a stem describing the clinical vignette with four choices. One of

the four choices will be correct but the other three must be diseases that are similar using the

principles of generating a differential diagnosis. For each disease state the student will write

three questions. One question involves the basic science or pathogenesis of the disease using a

stem and four choices that involve basic science concepts. One of the choices is correct but the

other three distractors must be similar in nature. For example: for an infectious disease an ap-

propriate question would involve the most common organism. The distractors would involve

other organisms that are incorrect. The second question must include pertinent history and physi-

cal exam findings in the stem of the question for each disease state. You must write a vignette

that incorporates the classical historical findings and pathognomonic physical exam findings for

that disease state. You would then write four choices with one of them being correct and the oth-

er three similar disorders that you might consider in your differential diagnoses.

BLOOM'S TAXONOMY LEVEL - EVALUATION:

Make judgments about the value of ideas or materials.

Assignment:

Write one advanced level question.

To achieve the level of evaluation the student would write a third question to build upon the first

two described in the synthesis section. The third question would involve the student writing a

vignette stem for the question involving clinical laboratory findings, radiographic findings or

other appropriate diagnostic information for each disorder in the blueprint. This must be written

in a real-life format using a patient. The question would ask how you would manage or treat this

disorder based upon just the diagnostic information. You must not write the disease name in the

stem. This will enable you to make connections using laboratory correlations and appropriate

intervention and treatments. You will construct four choices with one of the choices being the

62

correct treatment from your sources. The other three choices would be similar in nature but not

appropriate for that particular disease state. If there is a “treatment of choice“, this must be pre-

sented in this question as the correct answer.

After completing the required clerkship assignments in the Classroom to Clinic Study System:

Personal Professor for Clinical Rotations and PANCE/PANRE Review, the student will print out

the blueprint topic questions described above and download the assignment into a personal elec-

tronic notebook or print them out organized into topics assigned to each clerkship. The student

may also elect to organize the vignette and questions for each topic into organ system modules.

These student-generated questions will be reviewed by faculty and received for credit. The final

product should be a vehicle to assist the student when studying for end-of-rotation examinations

and ultimately for the PANCE examination. The student constructed vignette and questions

should be considered a portfolio in which the information is organized into a binder for each

clerkship. During the clinical year, students are required to complete the assignment for all 498

high-impact notes in the Classroom to Clinic study system. In the clinical year, these vignettes

and questions will be used to study for both the end-of-rotation examinations and the program

summative examinations.. This portfolio will also be a required component of the summative

cognitive assessment process.

Students will be required to compile the questions generated from the Classroom to Clinic study

system for every topic assigned during each clerkship during the clinical year. Students are also

required to complete the pretests in the assigned chapter in the Classroom to Clinic study system

during each clerkship and the posttests in the CD.

Evaluation of Knowledge Obtained From High-Impact Notes

Students will be required to compile the clinical vignette questions generated from the Class-

room to Clinic Study System for every topic assigned during each clerkship during the clinical

year. Students are also required to complete the pretests in the assigned chapter in the Classroom

to Clinic Study System during each clerkship and the post-tests in the CD. Additionally, students

will be required to complete the following:

1. PANCE simulation examinations SUMM I, PACKRAT, and comprehensive examination

SUMM II.

2. Each student will receive a predicted score that will guide the final study process in the last

3 months prior to graduation.

The following assessment techniques will be employed:

Completion of self-authored high impact study notes. Each portfolio will be compiled either

electronically or as hard copies in binders that will be reviewed by the course instructor to

determine that it, at least, meets the minimal competency level for the self-authored prepara-

tory notes.

Completion of the PANCE formative exam called PACKRAT and SUMM I and a cognitive

summative exam called SUMM II which is used to identify individual student’s strengths and

weaknesses in preparation for the PANCE taken after graduation from the program.

To receive passing grades in PA 631/632/633 students must complete all elements of the Courses; including satisfactory completion of their self- authored clinical vignette and question portfolio, SUMM I, PACKRAT, SUMM II. The minimum passing score includes a score of

63

SUMM I

SUMM II PACKRAT PANCE Predicted

Score

216.19 513.28 138.45 458.25

Any student who scores below the above benchmarks will be required to sign a student study contract. A copy of his contract is provided in Appendix R. If a student does not achieve the benchmarks above on the SUMM I, SUMM II, and PACKRAT they are required to schedule an appointment with your advisor to discuss the study contract and sign this agreement. If the stu-dent does not undergo the required mentoring session they will receive an Incomplete in the course which can only be removed by completing this requirement.

ORAL PRESENTATIONS

The oral presentation is based on an actual patient case in which the student has taken an active

role. The faculty advisor, other MSPAS faculty member(s), and fellow students, will attend the

oral presentation. All present can participate in a discussion of the presentation, but only the

faculty members will grade the student presenting. One presentation will be made at the end of

each semester; the program will schedule the dates for the presentations. These presentations

will be conducted in a manner similar to Grand Rounds.

The objectives for the oral presentation are:

To present concisely pertinent medical history and physical examination findings to other

health care professionals

To formulate and discuss problem lists, assessments, and probable differential diagnoses

To review treatment plans and the indications for laboratory tests and imaging studies

To describe disease entities in an informed and professional manner appropriate to the level

of education

To discuss the clinical course and outcomes of the treatment plan

The topic of the presentation must be submitted to the faculty advisor at least two weeks before

the scheduled presentation. In addition, students must submit the following written materials on

the day of the presentation:

History & Physical Examination

Admitting Orders (if applicable)

SOAP Notes (if applicable)

Off-service or discharge note (if applicable)

Oral presentations will be graded according to a rubric created by the program (see Appendix O).

The oral presentation grade will be weighted as 10% of the semester grade during each semester

in the clinical year.

64

CLINICAL EVALUATION

ROTATION GRADING

A grade for each clinical rotation is derived as follows:

Rotation grades will be determined from the list below. If the student’s grand rounds-type

presentation is given at the end of this rotation, it will be graded as Pass/Fail. If a passing grade

is not given, the student will receive an “Incomplete” until competency is achieved.

The final grade for this course will be calculated using the following percentages for each

module:

Final Evaluation from Preceptor 50%

End-of-Rotation Examination 25%

Professional Seminar Attendance 10%

Required Electronic Entries 15%

Includes weekly reports, student

evaluation of preceptors, and patient

encounters

Total 100%

The criterion for a failing grade for a rotation is any one of the following:

1. Failure to submit written assignments meeting program standards

2. Failing evaluation by the clinical preceptor

3. Excessive or unexcused absences from the rotation site

4. Overall rotation grade below 2.0 in any of the main competency areas

A student may be required to repeat a failed clinical rotation at the discretion of the Program Di-

rector. The Program Director will consult with the Director of Clinical Education and the stu-

dent’s faculty advisor in deciding whether a student must repeat the rotation. The time and loca-

tion of the repeated rotation will be at the discretion of the Director of Clinical Education and

may result in delayed graduation.

REMEDIATION PROCEDURES

STANDARD C3.03: The program must monitor and document the progress of each student in a manner

that promptly identifies deficiencies in knowledge or skills and establishes means for remediation.

Written Assignments All required written assignments related to rotations are submitted by every student to their fac-

ulty advisor for evaluation. The faculty advisor will counsel the student regarding the quality of

the work and assist with any needed corrections.

A failing grade on a written assignment results in a failing grade for the related rotation.

65

Preceptor Evaluations

A failing grade on a preceptor evaluation will cause a student to fail the associated rotation. If a

student fails a core rotation, he or she will be required to complete the rotation successfully at a

later date. The director of clinical education has the authority to overrule a preceptor’s assess-

ment.

If a student receives low but passing grades on a preceptor evaluation, the faculty advisor will

arrange a meeting to discuss the cause and suggest a solution.

TIPS FOR SUCCESS ON ROTATIONS

Know the Clinical Site

You must contact most preceptors at least 2-3 weeks prior to starting a new clerkship. Find

out about parking, IDs, etc.

Every effort has been made to maintain and update appropriate contact information for clinical

sites. Nevertheless, minor problems may occur. It is necessary to maintain professionalism and

flexibility when faced with such changes. First, try to resolve any discrepancies on your own.

Call the Director of Clinical Education if this is not possible. Notify the Director of Clinical Ed-

ucation of any errors in supplied instructions so corrections can be made.

Find out what available conferences you might attend (grand rounds, daily/weekly conferences,

CME presentations, etc.).

Things to Discuss with Your Preceptor

Confirm your time schedule and specific duties (when to report to your clerkship, on-call sched-

ule, rounds, weekend hours, etc.).

Identify special interests, whether it is procedures or particular cases relevant to the clerkship.

Talk to preceptors about remaining mandatory technical procedures required and your eagerness

to complete them.

Ask what is expected of you. Where you are to be and at what time?

Additional Considerations

What you gain from the clerkship is equal to the effort you put forth.

In general, preceptors will give students as much hands-on experience as the preceptor feels you

are capable of handling.

Be courteous and pleasant to everyone.

Develop and maintain a professional attitude.

Be helpful to the preceptor and staff.

Read about the disease processes you encounter each day.

Take initiative.

You may encounter harsh criticisms at times. Try to learn from the feedback. Do not be argu-

mentative.

Be prepared to discuss and answer questions about any disease or procedure encountered during

your rotation.

66

Be prepared to study and read at least two hours per day.

You may not always be permitted to write on charts. If this is the case at your site, practice

writing notes on separate sheets and have preceptors critique them.

While on rotations, actively look for work that you can do to help improve patient care.

Report early, stay late, volunteer for call

If any concerns arise during rotations, please notify the Director of Clinical Education as

soon as possible. If unable to contact the DCE, please contact another program faculty mem-

ber.

ROTATION SUMMARY

The table below summarizes assignments associated with clinical rotations:

Assignment Responsibility Format Due

Review of Goals and Objec-tives

Student and Preceptor Paper First week of each rotation

Mid-rotation Review Student and Preceptor Paper Midpoint of each rotation

End of Rotation Evaluation Preceptor Paper or online Last day of each rotation

Student Evaluation of Clinical Site

Student Online Last day of each rotation

Written Materials (i.e., H&P) Student Paper Last day of each rotation

EORE (if applicable)

Student Online Last day of each rotation

Oral Presentation Student Presentation Once, near end of semester

ROTATION GOALS AND OBJECTIVES

GENERAL GOALS AND OBJECTIVES FOR ALL CLINICAL ROTATIONS

The goals within each clinical rotation are designed to help you achieve the knowledge, profi-

ciency, and expertise cited below. This is a guide, however, and not an all-inclusive list. Each

service should make available a full range of experiences that will provide the student with expo-

sure to each discipline's special procedures, techniques, and problems. The following general

goals and objectives are expected of all students while on clinical rotations.

MEDICAL HISTORY

Approach a patient in any clinical setting and establish appropriate rapport with the patient

and the patient's family.

Determine the appropriate format of historical data collection, which may include a complete

history, a directed outpatient history, or a directed inpatient follow-up history.

67

Determine the best (most appropriate) source of historical data when the patient is unable to

provide the information.

Elicit a complete medical history that should include:

o Determination of the chief complaint

o Analysis of the primary symptomatology: onset and duration; precipitating and pre-

disposing factors; characteristics of symptoms from onset to present including quali-

ty, location, radiation, and intensity or severity; temporal character; aggravating and

relieving factors; and associated symptoms

o Review of the course since onset of primary symptom: incidence, progress, and effect

of therapy

o Organization of a clear and concise history of present illness that carefully outlines

the chief complaint in addition to the pertinent past medical history, family history,

social/occupational history, allergies, and appropriate review of systems

o Organization of a complete past history that includes childhood medical history, adult

medical history, history of previous surgery, history of previous hospitalizations, his-

tory of injuries, allergies, and immunizations

o Organization of a complete family history that includes a review of the health status

of all members of the immediate family as well as a history of familial disease

o Organization of a complete social history that includes social habits, military history,

occupational history, marital history, educational history, sexual history, environmen-

tal conditions, and social support systems

o Organization of a complete review of symptoms that includes all of the positive and

negative symptomatology that the patient may have experienced in the recent past.

Provide written documentation of a complete medical history in a format approved by the

faculty of the MSPAS program.

PHYSICAL EXAMINATION

Determine the appropriate parts of the physical examination that should be performed in a

variety of clinical settings, including inpatient, outpatient, emergency, and long term care fa-

cilities.

Perform an appropriate physical examination and recognize normal and abnormal findings.

Perform the physical examination while maintaining an awareness of, and responding to, the

patient's discomfort and/or apprehension.

68

Perform the physical examination utilizing all diagnostic equipment properly (e.g., stetho-

scope, otoscope, ophthalmoscope, tuning fork, percussion hammer, etc.).

Perform the physical examination using proper techniques of physical examination (e.g.,

technique of percussion, palpation, auscultation, and inspection, as well as special maneuvers

such as straight leg raise or testing for meningeal or peritoneal irritation).

Provide written documentation of the findings of the physical examination in a clear and

concise manner using a format approved by the faculty of the MSPAS program.

ANCILLARY STUDIES

Make recommendations, based on the data gathered in the history and physical examina-

tion, for ancillary studies that should be ordered to evaluate further the patient's problem.

This may include radiologic studies, blood, urine or sputum analysis, and any other spe-

cial studies that may be of value.

DIAGNOSTIC ANALYSIS

Analyze the data gathered in the history, physical examination, and ancillary studies in

order to:

o Develop a problem list

o Formulate a differential diagnosis (assessment)

THERAPEUTIC ANALYSIS:

Formulate an appropriate plan of specific treatment and supportive care based on the problem

list and assessment.

Revise the therapeutic approach as the patient's condition changes and/or as new data are

available.

Counsel, educate, and instruct patients in specific disease-related and preventive medicine

areas such as diabetes care, breast self-examination, etc.

Acquire general knowledge of, and utilize appropriately, the referral sources within the

health care facility and the community.

GENERAL SKILLS AND PROCEDURES

Perform and become proficient in the following procedures:

A. Venipuncture

B. Initiation of intravenous infusions

C. Placement of nasogastric tubes

D. Administration of intradermal tests

69

E. Administration of medications - i.e., topical, oral, IM, and IV

F. Obtain and interpret electrocardiograms

G. Aseptic technique

H. Isolation technique

I. Perform CBC, urinalysis and other office laboratory procedures as indicated includ-

ing gram stains, acid-fast stain, stool guaiac, etc.

J. Collect specimens for blood cultures, urine cultures, and stool cultures

K. Draw arterial blood

L. Prepare and interpret cultures

M. Obtain Papanicolaou cytosmears

N. Perform CPR and defibrillation

O. Assisted respiration - i.e., familiarity with respirators

P. Insertion of urinary bladder catheters

Q. Proctoscopy

R. Wound care and dressing changes

S. Suturing and suture removal

T. Insert central lines

U. Perform endotracheal intubation

V. Insert chest tubes

W. Perform thoracentesis

X. Perform paracentesis

The students will, under direct or indirect supervision, observe, assist in, or perform all appropri-

ate procedures relative to the patients they are following at the discretion of the students' super-

vising physician. The students will also be available, when time permits, to assist in other pro-

cedures involving patients other than their own.

GOALS AND OBJECTIVES FOR SPECIFIC ROTATIONS

Throughout all clinical rotations, the student will continue to refine the knowledge and skills out-

lined above as general goals and objectives. The goals and objectives on the following pages are

designed to provide more information for specific rotations.

The following pages also contain a reading list and suggested references for each rotation. The

topics on these reading lists are drawn from the PANCE Blueprint and are intended to serve as a

starting point for your studies. Neither the PANCE Blueprint nor these reading lists are intended

to be completely comprehensive.

70

AMBULATORY MEDICINE Physician Assistant 601 Ambulatory Medicine

Credits

5 Semester Hours

Catalog Description

The five-week rotation provides practical experience in general primary care through outpatient medicine.

Students engage in all aspects of patient care, including history-taking, physical examination, treatment

plan design, and evaluation. Students’ application of patient and family education to treatment and pre-

ventive measures is emphasized.

Prerequisites/Co-requisites (if applicable)

Admission to the clinical year of the program

Suggested References

1. South-Paul et al, Current Diagnosis and Treatment: Family Medicine

2. Goldman et al. Cecil Textbook of Medicine

3. Townsend et al. Sabiston. Textbook of Surgery

4. Nelson. Textbook of Pediatrics

5. Hacker. Textbook of Obstetrics and Gynecology

Curriculum Goals Addressed by the Course

Goal 1: Develop the ability to perform a complete physical examination and to organize, integrate, inter-

pret and present clinical data in a clear, concise manner.

Goal 2: Support effective and sensitive communication with patients.

Goal 3: Develop critical thinking and evaluative skills

Goal 4: Develop effective communication and teamwork skills with health care teams

Goal 5: Provide a comprehensive approach to normal human health and development, both physical and

mental

Goal 6: Provide an explanation and demonstration of the skills needed to assess core diseases encountered

in primary care

Goal 7: Integrate diagnostic assessment skills with knowledge of patient presentation, pharmacology and

health care subspecialties to synthesize appropriate treatment plans.

Goal 8: Promote cross-cultural and socioeconomic sensitivity, confront prejudice, and support the devel-

opment of effective medical practice in a diverse society

Goal 9: Promote a commitment to provide effective, accessible, continuous, comprehensive, and person-

alized health care.

Goal 10: Emphasize the fundamental importance of ethical behavior in medical practice.

Goal 11: Promote teaching of patients, community and colleagues

Goal 12: Participate in the generation of new knowledge in medicine, whether through research, health

policy administration, or as distinguished practitioners.

Goal 13: Develop cutting edge knowledge of the Physician Assistant profession and participate as leaders

at the local, state, and national level shaping future policy and legislation to promote Physician Assistant

practice

71

Goal 14: Apply knowledge of study designs and statistical methods to the appraisal of clinical studies and

other information on diagnostic and therapeutic effectiveness, and integrate evidence from scientific stud-

ies related to their patients’ health problems

Goal 15: Apply knowledge of basic science concepts to facilitate understanding of the medical sciences

Goal 16: Demonstrate competency in basic clinical procedures performed by a graduate Physician Assis-

tant

Course Objectives

Perform problem oriented evaluation of patients with new complaints and established diagnoses

Perform comprehensive pediatric examinations for all stages of development from newborn to ado-

lescent, including preventative screenings and anticipatory guidance with patient and family educa-

tion (if applicable)

Perform comprehensive examinations for all aged female patients, including preventative screenings and prenatal care with patient and family education

Perform diagnostic procedures as indicated and directed to do so by a supervising provider

Demonstrate patient management plans with provider supervision

Maintain all patient encounters in electronic data base used by the Physician Assistant Program

Submit Weekly Reports and other paperwork as required by the Physician Assistant Program

Attend all educational conferences/meetings/lectures offered by the clinical site and/or preceptor

when possible

Participate in after-hour call if available

If possible the student should perform or participate in the following procedures:

- Phlebotomy / IV placement

- Pap smears

- Skin biopsies

- Prenatal examinations (if applicable)

- Well-child physicals (if applicable)

- Ultrasound fetal examinations (if applicable)

- EKG lead placement and interpretation

- Pulmonary Function Testing

- Cardiac Stress Testing

- Suturing

- Splinting

- Audiometry

- Tympanometry

- Injections for Vaccinations

72

The following is a list of End of Rotation Examination Topics for this Rotation

Pulmonary System:

Infectious Disorders

Acute bronchitis

Pneumonias

• Bacterial

• Viral

Obstructive Pulmonary Disease

Asthma

Tuberculosis

Lung cancer

Tobacco use/dependence

Sleep disorders

Cardiovascular System:

Hypertension

Coronary artery disease

Peripheral vascular disease

Arrhythemias

Endocarditis

Hyperlipidema

Hypertriglyceridema

Angina

Congestive Heart Failure

Chest Pain

Valvular disease

EENT (Eyes, Ears, Nose and Throat):

Eye Disorders

• Blepharitis

• Chalazion

• Conjunctivitis

• Dacryoadenitis

• Ectropion

• Entropion

• Hordeolum

• Pterygium

• Corneal abrasion

• Corneal ulcer

• Glaucoma

• Hyphema

• Macular degeneration

• Papilledema

• Retinal detachment

• Retinal vascular occlusion

• Retinopathy

• Cholesteatoma

Ear Disorders

• Cerumen impaction

• Mastoiditis

• Meniere's disease

• Labyrinthitis

• Otitis externa/media

• Vertigo

• Tinnitus

• Tympanic membrane perforation

Nose/Sinus Disorders

• Acute/chronic sinusitis

• Nasal polyps

• Allergic Rhinitis

• Epistaxis

Mouth/Throat Disorders

• Acute pharyngitis

• Acute tonsillitis

• Dental abscess

• Laryngitis

• Parotitis

• Sialadenitis

• Aphthous ulcers

• Peritonsillar abscess

Gastrointestinal System/Nutrition

Esophagitis

Stomach

• Gastroesophageal reflux disease

• Gastritis

• Peptic ulcer disease

• Gastroenteritis

• Gastrointestinal bleeding

Pancreatitis

Appendicitis

Viral Hepatitis

Jaundice

Cholecystitis/Cholelithiasis

Cirrhosis

Giardiasis/parasitic infections

Hiatal hernia

Small Intestine/Colon

• Irritable bowel syndrome

• Inflammatory bowel disease

Rectum

• Anal fissure

• Fecal impaction

• Colorectal Cancer

• Diarrhea/Constipation

• Hemorrhoids

• Bowel obstruction

Genitourinary System

Infectious/Inflammatory Conditions

Cystitis

Epididymitis

Orchitis

73

Prostatitis

Urethritis

Hernias

Pyelonephritis

Glomerulonephritis

Nephrolithiasis

Benign prostatic hypertrophy

Balanitis

Testicular Cancer

Musculoskeletal System

Disorders of the Forearm/Wrist/Hand

• Tenosynovitis

• Carpal tunnel syndrome

• de Quervain's tenosynovitis

• Elbow tendinitis

• Epicondylitis

• Ganglion cysts

Costochondritis

Rhematoid arthritis

Osteoarthritis

Reactive arthritis

Gout

Systemic Lupus Erythematosus

Fibromyalgia

Plantar Fasciitis

Overuse syndrome

Disorders of the Back/Spine

• Kyphosis/scoliosis

Low back pain

• Disorders of the Knee

• Bursitis

• Neoplastic Disease

Dermatologic System

Eczematous Eruptions

• Nummular

Dermatitis

• Atopic

• Contact

• Nummular eczematous

• Perioral

• Seborrheic

• Stasis

Dyshidrosis

Lichen simplex chronicus

Papulosquamous Diseases

Dermatophyte infections

• Tinea versicolor

Lichen planus

Acneiform Lesions

Rosacea

Folliculitis

Verrucous Lesions

Seborrheic keratosis

Actinic keratosis

Basal Cell Carcinoma

Kaposi’s sarcoma

Melanoma

Cellulitis

Erysipelas

Impetigo

Hidradenitis suppurativa

Hair and Nails

• Alopecia areata

• Androgenetic alopecia

• Onycomycosis

Paronychia

Viral Diseases

Molluscum contagiosum

Drug Eruptions

Acanthosis nigricans

Melasma

Vitiligo

Pityriasis rosea

Psoriasis

Erythema mulitforme

Steven-Johnson Syndrome

Toxic Epidermal Necrolysis

Bullous pemphigoid

Lice

Scabies

Lipomas/epithelial inclusion cysts

Pilonidal disease

Pressure ulcers

Urticaria

Folliculitis

Hematologic System

Iron deficiency

Anemia

Leukemia

Thrombocytopenia

Clotting disorders

Lymphomas

Polycythemia

Endocrinology Diabetes mellitus

Adrenal Insufficiency

Cushing’s disease

Hyperthyroidism

Hypothyroidism

74

Reproductive System

Dysmenorrheal

Dysfunctional uterine bleed

Vaginitis

Pelvic Inflammatory Disease

Breast mass

Breast cancer

Cystocele

Rectocele

Menopause

Intrauterine pregnancy

Contraception

Cervical Cancer

Spontaneous abortion

Neurology

Dizziness

Syncope

Seizure disorder

Transient ischemic attack

Cerebral Vascular Accident

Alzheimer’s disease

Parkinson’s disease

Essential Tremor

Bell’s Palsy

Dementia

Delirium

Headaches (Cluster, migraine, tension)

Urgent Care

Respiratory Failure

Deteriorating Mental Status/Unconscious Pt

Allergic Reaction/anaphylaxis

Acute Abdomen

Burns

Third Trimester Bleeding

Bites/Stings

Foreign Body Aspiration

Cardiac Failure/Arrest

Fractures/Dislocations

Sprains/Strains

Myocardial Infarction

Hypertensive Crisis

Pulmonary Embolus

Pneumothorax

Ingesting Harmful Substances (poisoning)

Orbital Cellulitis

Infectious Diseases

Bacterial Disease

Chlamydia

Gonorrhea

Parasitic Disease

• Amebiasis

• Spirochetal Disease

Lyme borreliosis

• Lyme disease

Rocky Mountain spotted fever

Viral Disease

Influenza

Mononucleosis

HIV

Meningitis

Salmonellosis

Shigellosis

Psychiatry/Behavioral Science

Depression

Generalized Anxiety disorder

Panic Disorder

Phobias

Post-traumatic stress disorder

Insomnia

Anorexia

Bulimia

Mood disorders

Substance Abuse disorders

Domestic Violence

Suicide

75

INTERNAL MEDICINE Physician Assistant 603 Internal Medicine

Credits

5 Semester Hours

Catalog Description

The five-week rotation provides practical clinical experience in internal medicine. Students engage in all

aspects of patient care, including history, physical examination, treatment plan design, and evaluation.

Students’ application of patient and family education to treatment and preventive measures is emphasized.

Prerequisites/Co-requisites (if applicable)

Admission to the clinical year of the program

Curriculum Goals Addressed by the Course

Goal 1: Develop the ability to perform a complete physical examination and to organize, integrate, inter-

pret and present clinical data in a clear, concise manner.

Goal 2: Support effective and sensitive communication with patients.

Goal 3: Develop critical thinking and evaluative skills

Goal 4: Develop effective communication and teamwork skills with health care teams

Goal 5: Provide a comprehensive approach to normal human health and development, both physical and

mental

Goal 6: Provide an explanation and demonstration of the skills needed to assess core diseases encountered

in primary care

Goal 7 Integrate diagnostic assessment skills with knowledge of patient presentation, pharmacology and

health care subspecialties to synthesize appropriate treatment plans.

Goal 8: Promote cross-cultural and socioeconomic sensitivity, confront prejudice, and support the devel-

opment of effective medical practice in a diverse society

Goal 9: Promote a commitment to provide effective, accessible, continuous, comprehensive, and person-

alized health care.

Goal 10: Emphasize the fundamental importance of ethical behavior in medical practice.

Goal 11: Promote teaching of patients, community and colleagues

Goal 12: Participate in the generation of new knowledge in medicine, whether through research, health

policy administration, or as distinguished practitioners.

Goal 13: Develop cutting edge knowledge of the Physician Assistant profession and participate as leaders

at the local, state, and national levels shaping future policy and legislation to promote Physician Assistant

practice

Goal 14: Apply knowledge of study designs and statistical methods to the appraisal of clinical studies and

other information on diagnostic and therapeutic effectiveness, and integrate evidence from scientific stud-

ies related to their patients’ health problems

Goal 15: Apply knowledge of basic science concepts to facilitate understanding of the medical sciences

Goal 16: Demonstrate competency in basic clinical procedures performed by a graduate Physician Assis-

tant

76

Course Objectives

Students will:

Perform problem oriented evaluation of patients with new complaints and established diagnoses

Perform diagnostic procedures as indicated and directed to do so by a supervising provider

Demonstrate patient management plans with provider supervision

Perform comprehensive examinations for all adult patients, including preventative screenings, with

patient and family education

Maintain all patient encounters in electronic data base used by the Physician Assistant Program

Submit Weekly Reports and other paperwork as required by the Physician Assistant Program

Attend all educational conferences/meetings/lectures offered by the clinical site and/or preceptor

when possible

Participate in after-hour call if available

If possible the student should perform or participate in the following procedures:

o Phlebotomy / IV placement

o Pap smears

o Skin biopsies

o EKG lead placement and interpretation

o Pulmonary Function Testing

o Cardiac Stress Testing

Upon completion of the internal medicine clinical rotation, the student will be expected to demonstrate

basic knowledge of the following diseases and disorders seen in internal medicine practice:

Internal Medicine Reading List

Suggested Reference:

Goldman et al. Cecil Textbook of Medicine

The following is a list of End of Rotation Examination Topics for this Rotation

Cardiovascular System

Cardiomyopathy

• Dilated

• Hypertrophic

• Restrictive

• Congestive Heart Failure

• Myocardial Infarction

• Hypertension

• Essential

• Secondary

• Malignant

Ischemic Heart Disease

Cardiac Arrhythmias/Conduction disorders

Myocarditis

Pericarditis

Angina pectoris

•Stable

•Unstable

• Prinzmetal's/variant

Vascular Disease (peripheral, coronary)

Acute rheumatic fever

Giant cell arteritis

Valvular Disease (non-surgical)

Aortic stenosis/insufficiency

Mitral stenosis/insufficiency

Mitral valve prolapse

Tricuspid stenosis/insufficiency

Pulmonary stenosis/insufficiency

Other Forms of Heart Disease

Acute and subacute bacterial endocarditis

Hyperlipidemia

Rheumatic heart disease

Pulmonary System

Infectious Disorders

Pneumonias

• Fungal

• HIV-related

Tuberculosis

Obstructive Pulmonary Disease

Asthma

Bronchiectasis

Chronic bronchitis

Emphysema

77

Pulmonary Circulation

Pulmonary hypertension

Cor pulmonale

Restrictive Pulmonary Disease

Idiopathic pulmonary fibrosis

Pneumoconiosis

Sarcoidosis

Pulmonary neoplasm

Carcinoid tumor

Solitary pulmonary nodule

Hypoventilation syndrome

Endocrine System

Diseases of the Thyroid Gland

Hyperparathyroidism

Hypoparathyroidism

Hyperthyroidism

• Graves' disease

• Hashimoto's thyroiditis

• Thyroid storm

Hypothyroidism

Thyroiditis

Diseases of the Adrenal Glands

Cushing's syndrome

Corticoadrenal insufficiency

Diseases of the Pituitary Gland

Acromegaly/gigantism

Diabetes insipidus

Diabetes Mellitus

Type 1

Type 2

Hypoglycemia

Lipid Disorders

Hypercholesterolemia

Addison’s disease

Pheochromocytoma

Hypocalcemia

Hypercalcemia

Hyponatremia

Hypernatremia

Paget’s disease of the bone

Thyroid cancer

Pituitary adenoma

EENT (Eyes, Ears, Nose and Throat)

Eye Disorders

Macular degeneration

Retinopathy

• Diabetic

• Hypertensive

Gastrointestinal System/Nutrition

Esophagus

Esophagitis

Motor disorders

Stomach

Gastroesophageal reflux disease

Gastritis

Peptic ulcer disease

Liver

Acute/chronic hepatitis

Cirrhosis

Ulcerative Colitis

Crohn’s disease

Diverticular disease

Hiatal hernia

Gastroenteritis

Mallory-Weiss Tear

Esophageal strictures

Esophageal varices

Cancer of rectum, colon, esophagus, stomach

Hepatic cancer

Cholelithiasis

Cholecystitis

Cholangitis

Celiac Disease

Irritable Bowel syndrome

Anal fissure/fistula

Hemorrhoid

Acute/chronic pancreatitis

Infectious Diarrhea

Nutritional Deficiencies

Niacin

Thiamine

Vitamin A

Riboflavin

Vitamin C

Vitamin D

Vitamin K

Genitourinary System

Benign Conditions of the GU Tract

Benign prostatic hypertrophy

Prostate cancer

Prostatitis

Erectile dysfunction

Incontinence

Urinary tract infection

Hydrocele

Varicocele

Testicular Torsion

Epididymitis

Bladder cancer

Hypervolumia

78

Hypovolemia

Renal Diseases

Acute/chronic renal failure

Glomerulonephritis

Nephrotic syndrome

Polycystic kidney disease

Nephritis

Nephritic syndrome

Renal calculi

Pyelonephritis

Acute interstitial nephritis

Hydronephrosis

Renal cell carcinoma

Electrolyte and Acid/Base Disorders

Hypo/hypernatremia

Hypo/hyperkalemia

Hypo/hypercalcemia

Hypomagnesemia

Metabolic alkalosis/acidosis

Respiratory alkalosis/acidosis

Musculoskeletal System

Disorders of the Back/Spine

Ankylosing spondylitis

Acute/chronic osteomyelitis

Osteoarthritis

Osteoporosis

Fibromyalgia

Gout/pseudogout

Juvenile rheumatoid arthritis

Polyarteritis nodosa

Polymyositis

Polymyalgia rheumatic

Reiter's syndrome

Rheumatoid arthritis

Systemic lupus erythematosus

Scleroderma Sjogren's syndrome

Reactive arthritis

Systemic sclerosis (scleroderma)

Neurologic System

Alzheimer's disease

Diseases of Peripheral Nerves

Diabetic peripheral neuropathy

Guillain-Barre syndrome

Myasthenia gravis

Syncope

Intracranial tumors

Meningitis

Giant cell arteritis

Bell’s Palsy

Cerebral aneurysm

Concussion

Delirium

Dementia

Complex regional pain syndrome

Headaches

Cluster headache

Migraine

Tension headache

Encephalitis

Movement Disorders

Essential tremor

Huntington's disease

Parkinson's disease

Multiple Sclerosis

Seizure Disorders

Generalized convulsive disorder

Generalized non-convulsive disorder

Vascular Diseases

Stroke

Transient ischemic attack

Psychiatry/Behavioral Science

Eating Disorders-Obesity

Substance Use Disorders-Tobacco use and/or

dependence

Dermatologic System

Papulosquamous Diseases

Psoriasis

Desquamation

Stevens-Johnson syndrome

Erythema multiforme

Bullous pemphigoid

Hematologic System

Anemias

Aplastic anemia

Vitamin B12 deficiency

Folate deficiency

Iron deficiency

G6PD deficiency

Hemolytic anemia

Thalassemia

Coagulation Disorders

Factor VIII disorders

Factor IX disorders

Factor XI disorders

Thrombocytopenia

• Thrombotic thrombocytopenic purpura

• Von Willebrand's disease

79

Malignancies

Acute/chronic lymphocytic leukemia

Acute/chronic myelogenous leukemia

Lymphoma

Multiple myeloma

Sickle cell anemia

Anemia of chronic disease

Hypercoagulable state

Idiopathic thrombocytopenia purpura

Infectious Diseases

Chlamydia

Diptheria

Gonococcal infections

Pertussis

Lyme disease

Rocky Mountain Spotted Fever

Cytomegalovirus

Epstein-Barr infection

Influenza

Rabies

Varicella Zoster

Candidiasis

Cryptococcosis

Histoplasmosis

Pneumocystis

Bacterial Disease

Botulism

Cholera

Salmonellosis

Shigellosis

Tetanus

Mycobacterial Disease

Tuberculosis

Atypical mycobacterial disease

Parasitic Disease

Malaria

Toxoplasmosis

Spirochetal Disease

Syphilis

Viral Disease

HIV infection

Herpes simplex infection

Critical Care

Acute adrenal insufficiency

Thyroid Storm

Diabetic ketoacidosis/ acute hypoglycemia

Acute glaucoma

Pulmonary embolism

Acute respiratory distress/failure

Pneumothorax

Angina pectoris

Myocardial infarction

Cardiac arrest

Cardiac arrhythmias/blocks

Cardiac failure

Hypertensive crisis

Acute gastrointestinal bleed

Acute abdomen

Seizures

Shock

Coma

Cardiac tamponade

Pericardial effusion

Status epilepticus

80

PEDIATRICS

Physician Assistant 604 Pediatrics

Credits

5 Semester Hours

Catalog Description The five-week rotation provides practical clinical experience in pediatric medicine. Students engage in all

aspects of patient care, including history-taking, physical examination, treatment plan design and evalua-

tion. Students’ application of patient and family education to treatment and preventive measures is em-

phasized.

Prerequisites/Co-requisites (if applicable)

Admission to the clinical year of the program

Suggested References

Nelson’s Textbook of Pediatrics

Curriculum Goals Addressed by the Course

Goal 1: Develop the ability to perform a complete physical examination and to organize, inte-

grate, interpret and present clinical data in a clear, concise manner.

Goal 2: Support effective and sensitive communication with patients.

Goal 3: Develop critical thinking and evaluative skills

Goal 4: Develop effective communication and teamwork skills with health care teams

Goal 5: Provide a comprehensive approach to normal human health and development, both phys-

ical and mental Goal 6: Provide an explanation and demonstration of the skills needed to assess core diseases encountered

in primary care

Goal 7 Integrate diagnostic assessment skills with knowledge of patient presentation, pharma-

cology and health care subspecialties to synthesize appropriate treatment plans.

Goal 8: Promote cross-cultural and socioeconomic sensitivity, confront prejudice, and support the

development of effective medical practice in a diverse society

Goal 9: Promote a commitment to provide effective, accessible, continuous, comprehensive, and

personalized health care.

Goal 10: Emphasize the fundamental importance of ethical behavior in medical practice.

Goal 11: Promote teaching of patients, community and colleagues

Goal 12: Participate in the generation of new knowledge in medicine, whether through research,

health policy administration, or as distinguished practitioners.

81

Goal 13: Develop cutting edge knowledge of the Physician Assistant profession and participate

as leaders at the local, state, and national level shaping future policy and legislation to promote

Physician Assistant practice

Goal 14: Apply knowledge of study designs and statistical methods to the appraisal of clinical

studies and other information on diagnostic and therapeutic effectiveness, and integrate evidence

from scientific studies related to their patients’ health problems

Goal 15: Apply knowledge of basic science concepts to facilitate understanding of the medical

sciences

Goal 16: Demonstrate competency in basic clinical procedures performed by a graduate Physi-

cian Assistant

Course Objectives

Perform problem oriented evaluation of patients with new complaints and established di-

agnoses

Perform diagnostic procedures as indicated and directed to do so by a supervising provid-

er

Demonstrate patient management plans with provider supervision

Perform comprehensive examinations for all adult patients, including preventative

screenings, with patient and family education

Maintain all patient encounters in electronic data base used by the Physician Assistant

Program

Submit Weekly Reports and other paperwork as required by the Physician Assistant Pro-

gram

Attend all educational conferences/meetings/lectures offered by the clinical site and/or

preceptor when possible

Participate in after-hour call if available

If possible the student should perform the following procedures:

- Phlebotomy / IV placement

- Splinting

- Suturing

- Audiometry

- Tympanometry

- Injections for Vaccinations

82

Upon completion of the pediatric clinical rotation, the student will be expected to demonstrate

basic knowledge of the following diseases and disorders seen in pediatric practice:

Cardiovascular System

Congenital Heart Disease

Atrial septal defect

Coarctation of aorta

Patent ductus arteriosus

Tetralogy of Fallot

Ventricular septal defect

Acute rheumatic fever

Kawasaki disease

Hypertrophic cardiomyopathy

Syncope

Pulmonary System

Acute bronchiolitis

Asthma

Acute epiglottitis

Croup

Influenza

Pertussis

Pneumonias

Respiratory syncytial virus infection

Obstructive Pulmonary Disease

Cystic fibrosis

Other Pulmonary Disease

Hyaline membrane disease

Foreign body aspiration

Endocrine System

Dwarfism

Hyperthyroidism

Hypothyroidism

Hypercalcemia

Obesity

Diabetes mellitus

EENT (Eyes, Ears, Nose and Throat)

Eye Disorders

• Orbital cellulites

• Strabismus

• Conjunctivitis

Ear Disorders

• Acute/chronic otitis media

• Hearing impairment

• Otitis externa

• Tympanic membrane perforation

• Mastoiditis

Nose/Sinus Disorders

• Allergic rhinitis

• Epistaxis

Mouth/Throat Disorders

• Acute pharyngitis

• Acute tonsillitis

• Aphthous ulcers

• Epiglottitis

• Oral candidiasis

• Oral herpes simplex

• Peritonsillar abscess

Gastrointestinal System/Nutrition

Stomach

• Pyloric stenosis

• Gastroenteritis

• GERD

Appendicitis

Dehydration

Colic

Hirschsprung’s disease

Foreign body ingestion

Encopresis

Hepatitis

Jaundice

Duodenal atresia

Inguinal hernia

Umbilical hernia

Small Intestine/Colon

• Constipation

• Inflammatory bowel disease

• Intussusception

Nutritional Deficiencies

• Niacin

• Thiamine

• Vitamin A

• Riboflavin

• Vitamin C

• Vitamin D

• Vitamin K

Metabolic Disorders

• Lactose intolerance

• Phenylketonuria

83

Genitourinary System

Benign Conditions of the GU Tract

Cryptorchidism

Hydrocele/varicocele

Paraphimosis/phimosis

Testicular torsion

Enuresis

Hypospadias

Vesicourethral reflux

Glomerulonephritis

Cystitis

Neoplastic Diseases

Wilms' tumor

Musculoskeletal System

Disorders of the Forearm/Wrist/Hand • Nursemaid's elbow

Disorders of the Hip

Slipped capital femoral

Disorders of the Knee

Osgood-Schlatter disease

Neoplastic Disease

Osteosarcoma

Scoliosis

Congenital hip dysplasia

Avascular necrosis

Juvenile rheumatoid arthritis

Neurologic System

Cerebral Palsy

Infectious Disorders

Meningitis

Normal growth and development

Immunization guidelines

Anticipatory guidance

Teething

Febrile seizures

Epilepsy

Turner syndrome

Down syndrome

Psychiatry/Behavioral Science

ADHD

Autistic disorder

Eating disorders

Depression

Anxiety

Conduct disorders

Suicide

Child abuse

Dermatologic System

Eczematous Eruptions

Dermatitis

• Diaper

Perioral

Contact

Atopic

Papulosquamous Diseases

Dermatophyte infections

• Tinea corporis/pedis

Pityriasis rosea

Desquamation

Toxic epidermal necrolysis

Acneiform Lesions

Acne vulgaris

Insects/Parasites

Lice

Scabies

Viral Diseases

Exanthems

Herpes simplex

Verrucae

Varicella-zoster virus infections

Bacterial Infections

Impetigo

Drug eruptions

Lichen planus

Pityriasis rosea

Steven-Johnson syndrome

Erythema multiforme

Androgenic alopecia

Burns

Urticaria

Hematologic System

Anemias

Sickle cell anemia

Bleeding disorders

Coagulation Disorders

Leukemia

Lymphoma

Neutropenia

Brain tumors

Hemophilia

Lead poisoning

Thrombocytopenia

• Idiopathic thrombocytopenic purpura

84

Infectious Diseases

Parasitic Disease

Hookworms

Pinworms

Spirochetal Disease

Syphilis

Viral Disease

Cytomegalovirus infections

Epstein-Barr virus infections

Erythema infectiosum

Herpes simplex

Mumps

Roseola

Rubella

Measles

Varicella-zoster virus infections

Atypical mycobacterial disease

Hand foot mouth diesease

Pertusis

85

PSYCHIATRY Physician Assistant 605 Psychiatry

Credits

5 Semester Hours

Catalog Description

The five-week rotation provides practical clinical experience in psychiatric medicine. Students engage in

all aspects of patient care, including history-taking, physical examination, treatment plan design and eval-

uation. Students’ application of patient and family education to treatment and preventive measures is em-

phasized.

Prerequisites/Co-requisites (if applicable)

Admission to the clinical year of the program

Suggested References

Kay and Tasman’s Psychiatry: Behavioral Science and Clinical Essentials

Ebert et al. Current Diagnosis and Treatment Psychiatry

Goldman et al. Cecil Textbook of Medicine

Curriculum Goals Addressed by the Course

Goal 1: Develop the ability to perform a complete physical examination and to organize, inte-

grate, interpret and present clinical data in a clear, concise manner.

Goal 2: Support effective and sensitive communication with patients.

Goal 3: Develop critical thinking and evaluative skills

Goal 4: Develop effective communication and teamwork skills with health care teams

Goal 5: Provide a comprehensive approach to normal human health and development, both phys-

ical and mental Goal 6: Provide an explanation and demonstration of the skills needed to assess core diseases encountered

in primary care

Goal 7 Integrate diagnostic assessment skills with knowledge of patient presentation, pharma-

cology and health care subspecialties to synthesize appropriate treatment plans.

Goal 8: Promote cross-cultural and socioeconomic sensitivity, confront prejudice, and support the

development of effective medical practice in a diverse society

Goal 9: Promote a commitment to provide effective, accessible, continuous, comprehensive, and

personalized health care.

Goal 10: Emphasize the fundamental importance of ethical behavior in medical practice.

Goal 11: Promote teaching of patients, community and colleagues

Goal 12: Participate in the generation of new knowledge in medicine, whether through research,

health policy administration, or as distinguished practitioners.

86

Goal 13: Develop cutting edge knowledge of the Physician Assistant profession and participate

as leaders at the local, state, and national level shaping future policy and legislation to promote

Physician Assistant practice

Goal 14: Apply knowledge of study designs and statistical methods to the appraisal of clinical

studies and other information on diagnostic and therapeutic effectiveness, and integrate evidence

from scientific studies related to their patients’ health problems

Goal 15: Apply knowledge of basic science concepts to facilitate understanding of the medical

sciences

Goal 16: Demonstrate competency in basic clinical procedures performed by a graduate Physi-

cian Assistant

Course Objectives

Perform problem oriented evaluation of patients with new complaints and established diagnoses.

Demonstrate patient management plans with provider supervision.

Maintain all patient encounters in electronic data base used by the Physician Assistant Program.

Submit Weekly Reports and other paperwork as required by the Physician Assistant Program.

Attend all educational conferences/meetings/lectures offered by the clinical site and/or preceptor

when possible.

Participate in after-hour call if available.

Comprehend and utilize the following:

- Assessment tools (common office tools: e.g., the Beck scale)

- Pharmacotherapy, psychotherapy, and counseling

- DSM-IV

Upon completion of the psychiatry clinical rotation, the student will be expected to demonstrate basic

knowledge of the following disorders seen in psychiatric practice:

Anxiety Disorders

Panic disorder

Generalized anxiety disorder

Posttraumatic stress disorder

Phobias

Attention-Deficit Disorder

ADHD

Conduct disorder

Oppositional defiant disorder

Autistic Disorder

Eating Disorders

Anorexia nervosa

Bulimia nervosa

Obesity

Mood Disorders

Adjustment

Depressive

Dysthymic

Bipolar

Cyclothymia

Personality Disorders Antisocial

Avoidant

Borderline

Histrionic

Narcissistic

Obsessive-compulsive

Paranoid

Schizoid

Schizotypal

Psychoses

Delusional disorder

Schizophrenia

Schizoaffective disorder

87

Schizophreniform disorder

Somatoform Disorders

Dependent

Body dysmorphic disorder

Hypochondriasis

Factitious disorder

Malingering

Paraphilias & Sexual Dysfunction

Hypoactive sexual desire disorder

Sexual aversion disorder

Exhibitionism

Fetishism

Pedophilia

Sexual masochism

Voyeurism

Substance Use Disorders

Alcohol abuse/dependence

Drug abuse/dependence

Tobacco use/dependence

Other Behavior/Emotional Disorders

Acute reaction to stress

Uncomplicated bereavement

88

SURGERY Physician Assistant 606 General Surgery

Credits

5 Semester Hours

Catalog Description

The five-week rotation provides practical clinical experience in general surgery. Students engage in all

aspects of patient care, including history-taking, physical examination, treatment plan design and evalua-

tion. Students’ application of patient and family education to treatment and preventive measures is em-

phasized.

Prerequisites/Co-requisites (if applicable)

Admission to the clinical year of the program

Suggested References

Lawrence: Essentials of General Surgery

Lawrence: Essentials of Surgical Specialties

Townsend et al. Sabiston Textbook of Surgery

Curriculum Goals Addressed by the Course

Goal 1: Develop the ability to perform a complete physical examination and to organize, inte-

grate, interpret and present clinical data in a clear, concise manner.

Goal 2: Support effective and sensitive communication with patients.

Goal 3: Develop critical thinking and evaluative skills

Goal 4: Develop effective communication and teamwork skills with health care teams

Goal 5: Provide a comprehensive approach to normal human health and development, both phys-

ical and mental Goal 6: Provide an explanation and demonstration of the skills needed to assess core diseases encountered

in primary care

Goal 7 Integrate diagnostic assessment skills with knowledge of patient presentation, pharma-

cology and health care subspecialties to synthesize appropriate treatment plans.

Goal 8: Promote cross-cultural and socioeconomic sensitivity, confront prejudice, and support the

development of effective medical practice in a diverse society

Goal 9: Promote a commitment to provide effective, accessible, continuous, comprehensive, and

personalized health care.

Goal 10: Emphasize the fundamental importance of ethical behavior in medical practice.

Goal 11: Promote teaching of patients, community and colleagues

Goal 12: Participate in the generation of new knowledge in medicine, whether through research,

health policy administration, or as distinguished practitioners.

89

Goal 13: Develop cutting edge knowledge of the Physician Assistant profession and participate

as leaders at the local, state, and national level shaping future policy and legislation to promote

Physician Assistant practice

Goal 14: Apply knowledge of study designs and statistical methods to the appraisal of clinical

studies and other information on diagnostic and therapeutic effectiveness, and integrate evidence

from scientific studies related to their patients’ health problems

Goal 15: Apply knowledge of basic science concepts to facilitate understanding of the medical

sciences

Goal 16: Demonstrate competency in basic clinical procedures performed by a graduate Physi-

cian Assistant

Course Objectives

Students will:

Perform problem oriented evaluation of patients with new complaints and established diagnoses

Perform pre-operative clearances and post-operative care

Perform diagnostic procedures as indicated and directed to do so by a supervising provider

Demonstrate patient management plans with provider supervision

Maintain all patient encounters in electronic data base used by the Physician Assistant Program

Submit Weekly Reports and other paperwork as required by the Physician Assistant Program

Attend all educational conferences/meetings/lectures offered by the clinical site and/or preceptor

when possible

Participate in after-hour call if available

If possible the student should perform the following procedures:

- Phlebotomy / IV placement

- Endotracheal intubation

- Surgical scrub and gowning / gloving procedures

- Suturing

- Surgical tube placement and removal

- Central line placement

- Arterial Blood Gas sampling

- Punch /shave/ excisional /needle biopsy

- Foley catheter placement

- Assist in operative procedures

- Patient preparation: draping & skin preparation

- Local, regional and epidural anesthesia blocks

- Incision and drainage of abscesses

- Placement and change of sterile dressings

- Operation of laparoscopic cameras and instruments

- Nasogastric intubation

Upon completion of the general surgery clinical rotation the student will be able to:

Identify the special laboratory studies necessary for surgical patients preoperatively

Explain the fundamentals of wound care and wound healing. Explain how co-morbidities may affect

healing time and change wound management

90

Differentiate common suture materials and wound closure materials (stainless steel wire, catgut, silk,

synthetic non-absorbable, synthetic absorbable, tapes, staples and glues) and their appropriate use

sites

Specify common types of stitches including simple interrupted, simple running, running locking, sub-

cuticular, vertical mattress, horizontal mattress, and purse string stitch

Identify, evaluate and manage various chronic wounds and ulcers including:

- Venous stasis ulcers

- Decubitus ulcers

- Arterial ulcers

Explain the principles of fluid and electrolyte balance as it applies to the surgical patient, specifically:

composition of fluid compartments, regulation of electrolytes, disorders of volume, correction of elec-

trolyte imbalances, and disorders of acid-base balance

Evaluate bleeding and blood replacement as it applies to the surgical patient specifically: special tests

of hemostasis, causes of surgical bleeding, bleeding in the post-operative period, and blood and/ or

blood product replacement

Explain common surgical procedures; their indications, contraindications, and possible complications:

- Nasogastric intubation

- Urethral catheterization

- Vascular catheterization

- Arterial catheterization

- Phlebotomy

- Common primary care procedures:

Incision and drainage of abscesses (pilonidal)

Paronychia / felon treatment

Ingrown toenail removal

Subungual hematoma

Differentiate etiologies of fever in the post-operative period

Distinguish common types of anesthesia including, general anesthesia, regional blocks, and local an-

esthesia. Include commonly used medications for local anesthesia and possible complications and

contraindications:

- Discuss issues of general anesthesia including airway management and maintenance of neuro-

muscular blockade, and complications including malignant hyperthermia and aspiration pneu-

monitis.

- Discuss epidural and spinal anesthesia; their benefits and risks

- Discuss issues of the immediate post-anesthetic period including immediate recovery and most

common complications, nausea and vomiting, and pain management

Explain use and placement, and describe and evaluate information obtained from, a Swan-Ganz

catheter

Describe basic principles of organ transplantation including indications and contraindications for

transplantation, organs and tissues currently used for transplantation, criteria of establishing brain

death, laboratory studies needed for determining organ suitability for transplant, organ preservation,

and rejection

Explain and evaluate the following diagnostic tests; their indications, contraindications, and risks:

- Endoscopic retrograde cholangiopancreatography

- Esophagogastroduodenoscopy

- Percutaneous transhepatic cholangiography

- Radionuclide biliary scan (HIDA/PIPIDA)

- Ventilation-perfusion scan

Describe the following surgical procedures, their indications, contraindications and possible compli-

cations.

91

- Hernia repair

- Nissen Fundoplication

- Appendectomy

- Cholecystectomy (open and laparoscopic)

- Whipple resection (pancreaticojejunostomy)

- Mastectomy

- Radical

- Modified radical

- Simple

- Segmental (lumpectomy)

- Thyroid lobectomy

- Vascular surgery

- Carotid endarterectomy

- Femoral-popliteal bypass

- Varicose vein stripping

- Skin cancer techniques and removal guidelines

- Fasciotomy

- Escharotomy

Identify the following surgical landmarks, signs and areas:

- Hesselbach’s Triangle

- Triangle of Calot

- Charcot’s Triad

92

Upon completion of the general surgery clinical rotation, the student will be expected to demonstrate

basic knowledge of the following topics seen in surgical practice:

Cardiovascular System

Vascular Disease

Aortic aneurysm/dissection

Arterial embolism/thrombosis

Chronic/acute arterial occlusion

Peripheral vascular disease

Varicose veins

Valvular Disease

Aortic stenosis/insufficiency

Mitral stenosis/insufficiency

Mitral valve prolapsed

Tricuspid stenosis/insufficiency

Pulmonary stenosis/insufficiency

Chest pain/ history of angina

Syncope

Dyspnea on exertion

Claudication

Pulmonary System

Hemoptysis

Pleural effusion

Post-Op Pneumonia

Pneumothorax

• Traumatic

• Tension

Neoplastic Disease

Bronchogenic carcinoma

Carcinoid tumors

Metastatic tumors

Pulmonary nodules

Hematologic System

Easy bruising/bleeding

Anemia

Fatigue

Endocrine System

Hyperparathyroidism

Hyperthyroidism

Thyroid nodules

Adrenal carcinoma

Thyroid carcinoma

Pheochromocytoma

EENT (Eyes, Ears, Nose and Throat)

Eye Disorders

Cataract

Retinal detachment

Mouth/Throat Disorders

Oral leukoplakia

Gastrointestinal System/Nutrition

Anorexia

Hematemesis

Hematochezia

Peptic Ulcer Disease

Cholangitis

Gastric cancer

Pyloric stenosis

Actue/chronic pancreatitis

Pancreatic pseudocyst

Inflammatory bowel disease

Bariatric surgery

Esophagus

Neoplasms

Strictures

Varices

Stomach

Neoplasms

Gallbladder

Acute/chronic cholecystitis

Cholelithiasis

Hepatic Neoplasms

Pancreatic Neoplasms

Small Intestine/Colon

Appendicitis

Diverticular disease

Ischemic bowel disease

Neoplasms

Obstruction

Toxic megacolon

Rectum

Anorectal abscess/fistula

Hemorrhoids

Neoplasms

Pilonidal disease

Polyps

Hernia

Hiatal

Incisional

Inguinal

Umbilical

Ventral

93

Genitourinary System

Urinary retention

Wilm’s Tumor

Chronic renal failure (shunts/access)

Nephrolithiasis

Benign prostatic hyperplasia

Bladder carcinoma

Prostate carcinoma

Renal cell carcinoma

Testicular carcinoma

Reproductive System

Uterus

• Dysfunctional uterine bleeding

• Endometrial cancer

• Endometriosis/adenomyosis

Ovary

• Neoplasms

Cervix

• Carcinoma

Vagina/Vulva

• Neoplasm

Breast

• Abscess

• Carcinoma

• Fibroadenoma

• Fibrocystic breast disease

Musculoskeletal System

Disorders of the Shoulder

Rotator cuff disorders

Disorders of the Back/Spine

Cauda equina

Herniated nucleus pulposis

Disorders of the Hip

Fractures/dislocations

Disorders of the Knee

Fractures/dislocations

Meniscal injuries

Disorders of the Ankle/Foot

Fractures/dislocations

Neoplastic Disease

Bone cysts/tumors

Neurologic System

Cerebral aneurysm

Carotid disease

Subarachnoid hemorrhage

Subdural hematoma

Epidural hematoma

Dermatologic System

Neoplasms

Basal cell carcinoma

Melanoma

Squamous cell carcinoma

Post-operative drug eruptions

Post-operative urticarial

Burns

Cellulitis

Other

Decubitus ulcers/leg ulcers

Hidradenitis suppurativa

Lipomas/epithelial inclusion cysts

Risk Assessment

Cardiac disease: history of MI, unstable angina,

valvular disease, hypertension, arrhythmias,

heart failure

Pulmonary disease: history of asthma, COPD

Metabolic disease: history of diabetes, adrenal

insufficiency

Hematologic disease: history of clotting disor-

ders, anticoagulant use

Tobacco use

Substance abuse

Post-Op fever

Wound infections

DVT

Fluid/volume disorders

Electrolyte disorders

Acid/base disorders

94

OBSTETRICS AND GYNECOLOGY

Physician Assistant 607 Women’s Health

Credits

5 Semester Hours

Catalog Description

The five-week rotation provides practical clinical experience in women’s health. Students engage in all

aspects of patient care, including history-taking, physical examination, treatment plan design and evalua-

tion. Students’ application of patient and family education to treatment and preventive measures is em-

phasized.

Prerequisites/Co-requisites (if applicable)

Admission to the clinical year of the program

Suggested References

Goldman et al. Cecil Textbook of Medicine

Townsend et al. Sabiston Textbook of Surgery

Hacker. Textbook of Obstetrics and Gynecology

Lawrence: Essentials of General Surgery

Lawrence: Essentials of Surgical Specialties

Curriculum Goals Addressed by the Course

Goal 1: Develop the ability to perform a complete physical examination and to organize, inte-

grate, interpret and present clinical data in a clear, concise manner.

Goal 2: Support effective and sensitive communication with patients.

Goal 3: Develop critical thinking and evaluative skills

Goal 4: Develop effective communication and teamwork skills with health care teams

Goal 5: Provide a comprehensive approach to normal human health and development, both phys-

ical and mental Goal 6: Provide an explanation and demonstration of the skills needed to assess core diseases encountered

in primary care

Goal 7 Integrate diagnostic assessment skills with knowledge of patient presentation, pharma-

cology and health care subspecialties to synthesize appropriate treatment plans.

Goal 8: Promote cross-cultural and socioeconomic sensitivity, confront prejudice, and support the

development of effective medical practice in a diverse society

Goal 9: Promote a commitment to provide effective, accessible, continuous, comprehensive, and

personalized health care.

Goal 10: Emphasize the fundamental importance of ethical behavior in medical practice.

Goal 11: Promote teaching of patients, community and colleagues

Goal 12: Participate in the generation of new knowledge in medicine, whether through research,

health policy administration, or as distinguished practitioners.

95

Goal 13: Develop cutting edge knowledge of the Physician Assistant profession and participate

as leaders at the local, state, and national level shaping future policy and legislation to promote

Physician Assistant practice

Goal 14: Apply knowledge of study designs and statistical methods to the appraisal of clinical

studies and other information on diagnostic and therapeutic effectiveness, and integrate evidence

from scientific studies related to their patients’ health problems

Goal 15: Apply knowledge of basic science concepts to facilitate understanding of the medical

sciences

Goal 16: Demonstrate competency in basic clinical procedures performed by a graduate Physi-

cian Assistant

Course Objectives

Perform problem oriented evaluation of patients with new complaints and established diagnoses

Perform diagnostic procedures as indicated and directed to do so by a supervising provider

Demonstrate patient management plans with provider supervision

Perform comprehensive examinations for all aged patients, including preventative screenings and

prenatal care with patient and family education

Maintain all patient encounters in electronic data base used by the Physician Assistant Program.

Submit Weekly Reports and other paperwork as required by the Physician Assistant Program.

Attend all educational conferences/meetings/lectures offered by the clinical site and/or preceptor

when possible.

Participate in after-hour call if available

If possible the student should perform the following procedures:

- Phlebotomy / IV placement

- Vaginal delivery

- Pap smears

- STD screenings

- Pre-natal examinations

- Ultrasound examinations

- Colposcopy

- IUD placement

- Assist in Caesarian delivery

- Assist in operative procedures

Upon completion of the women’s health clinical rotation the student will be able to:

Demonstrate knowledge of the normal anatomy and physiology of the female breast and

reproductive system including:

- Abdominal wall

- Inguinal region

- Pudendum

- Bony pelvis

- Contents of the pelvic cavity

- Structures of the bony pelvis

- Placenta

96

Pathology: Recognize and assess the pathologic disease manifestations of benign and malig-

nant breast disease, gynecologic disease, and pregnancy

Physiology: Recognize and assess the elements of the normal menstrual cycle, hormone

changes of pregnancy and menopause

Recommend the appropriate management of a victim of rape including general office proce-

dures, legal issues and appropriate laboratory testing as well as treatment

Identify the presumptive, probable, and positive manifestations of pregnancy

Integrate the elements of prenatal care including.

- The initial office visit, including history-taking, physical examination, and laboratory

testing

- Subsequent visits

- Maternal well-being as a sign of fetal well-being

- Preparation for labor

- Nutrition in pregnancy

- Common complaints during pregnancy

- Drugs, cigarette smoking, and alcohol during pregnancy

- Other matters of concern during pregnancy

Assess fetal presentation, position, and lie

Assess the three stages of labor in terms of stages, transition points, and management of stag-

es

Specify aids to normal delivery:

- Episiotomy

- Induction of Labor

- Natural childbirth

Recognize and evaluate malpresentation and recommend management for the various types

of breech presentation

- Frank breech

- Complete breech

- Footling breech

Determine indications for Caesarean Section.

- Cephalo-pelvic disproportion

- Uterine inertia

- Placenta previa

- Premature separation of the placenta

- Malposition and malpresentation

- Preeclampsia-eclampsia

- Fetal distress

- Cord prolapse

- Diabetes, Erythroblastosis or other threatening conditions

- Carcinoma of the cervix

- The “X Factor”

- Cervical dystocia

- Previous uterine incision

Recognize common drugs that are teratogenic or fetotoxic

Recommend patient education relative to contraceptive choices including efficacy, risks, ben-

efits, contraindications, and availability

Define prevention of hemolytic disease of the newborn.

Apply appropriate postpartum education and care issues including postpartum depression

97

Define the following terms :

- Gravidity

- Parity

- Preterm infant

- Abortion

- Immature infant

- Premature infant

- Low birth weight infant

- Small-for-date infant

- Post mature infant

- Excessive size

- Neonatal interval

- Perinatal interval

- Nagele’s Rule

- Term fetus

Upon completion of the women’s health clinical rotation the student will be expected to demonstrate

basic knowledge of the following topics seen in women’s health practice:

Reproductive System

Breast cancer

Uterus

Dysfunctional uterine bleeding

Endometrial cancer

Endometriosis/adenomyosis

Leiomyoma

Metritis

Prolapse

Ovary

Cysts

Torsion

Neoplasms

Cervix

Carcinoma

Cervicitis

Dysplasia

Incompetent

Vagina/Vulva

Cystocele

Neoplasm

Prolapse

Rectocele

Vaginitis

Menstrual Disorders

Dysfunctional uterine bleeding

Amenorrhea

Dysmenorrhea

Premenstrual syndrome

Menopause

Breast

Abscess

Carcinoma

Fibroadenoma

Fibrocystic disease

Mastitis

Pelvic Inflammatory Disease

Other

Domestic violence

Sexual assault

Urinary incontinence

Contraceptive Methods

Infertility

Uncomplicated Pregnancy

Prenatal diagnosis/care

Normal labor/delivery

Physiology of pregnancy

Fetal position

Multiple gestation

APGAR scoring

Complicated Pregnancy

Abortion

Abruptio placentae

Dystocia

Ectopic pregnancy

Fetal distress

Gestational diabetes

Gestational trophoblastic disease

98

Choricocarcinoma

Incompetent cervix

Molar pregnancy

Multiple gestation

Placenta previa

Postpartum hemorrhage

Preeclampsia/ eclampsia

Pregnancy-induced hypertension

Premature rupture of membranes

Prolapsed umbilical cord

Preterm labor

Breech presentation

Rh incompatibility

Postpartum Care

Postpartum hemorrhage

Endometritis

Perineal laceration/ episiotomy care

Normal physiology changes of puerperium

Dermatologic System

Viral Diseases

Condyloma acuminatum

Infectious Diseases

Bacterial Disease

Chlamydia

Viral Disease

Human papillomavirus

Gonorrhea

Herpes Simplex

Trichomoniasis

Bacterial vaginosis

Atrophic vaginitis

Candidiasis

Syphilis

Chancroid

Lymphogranuloma venereum

99

EMERGENCY MEDICINE Physician Assistant 608 Emergency Medicine

Credits

5 Semester Hours

Catalog Description

The five-week rotation provides practical clinical experience in emergency medicine. Students engage in

all aspects of patient care, including history-taking, physical examination, treatment plan design and eval-

uation. Students’ application of patient and family education to treatment and preventive measures is em-

phasized.

Prerequisites/Co-requisites (if applicable)

Admission to the clinical year of the program

Suggested References

Goldman et al. Cecil Textbook of Medicine

Tintinalli et al. Emergency Medicine: A Comprehensive Study Guide

Ma et al. Emergency Medicine: Just

Curriculum Goals Addressed by the Course

Goal 1: Develop the ability to perform a complete physical examination and to organize, inte-

grate, interpret and present clinical data in a clear, concise manner.

Goal 2: Support effective and sensitive communication with patients.

Goal 3: Develop critical thinking and evaluative skills

Goal 4: Develop effective communication and teamwork skills with health care teams

Goal 5: Provide a comprehensive approach to normal human health and development, both phys-

ical and mental Goal 6: Provide an explanation and demonstration of the skills needed to assess core diseases encountered

in primary care

Goal 7 Integrate diagnostic assessment skills with knowledge of patient presentation, pharma-

cology and health care subspecialties to synthesize appropriate treatment plans.

Goal 8: Promote cross-cultural and socioeconomic sensitivity, confront prejudice, and support the

development of effective medical practice in a diverse society

Goal 9: Promote a commitment to provide effective, accessible, continuous, comprehensive, and

personalized health care.

Goal 10: Emphasize the fundamental importance of ethical behavior in medical practice.

Goal 11: Promote teaching of patients, community and colleagues

Goal 12: Participate in the generation of new knowledge in medicine, whether through research,

health policy administration, or as distinguished practitioners.

100

Goal 13: Develop cutting edge knowledge of the Physician Assistant profession and participate

as leaders at the local, state, and national level shaping future policy and legislation to promote

Physician Assistant practice

Goal 14: Apply knowledge of study designs and statistical methods to the appraisal of clinical

studies and other information on diagnostic and therapeutic effectiveness, and integrate evidence

from scientific studies related to their patients’ health problems

Goal 15: Apply knowledge of basic science concepts to facilitate understanding of the medical

sciences

Goal 16: Demonstrate competency in basic clinical procedures performed by a graduate Physi-

cian Assistant

Course Objectives

Perform problem oriented evaluation of patients with new complaints and established diagnoses

Perform diagnostic procedures as indicated and directed to do so by a supervising provider

Demonstrate patient management plans with provider supervision

Perform comprehensive examinations for all aged patients, including preventative screenings and

prenatal care with patient and family education

Maintain all patient encounters in electronic data base used by the Physician Assistant Program.

Submit Weekly Reports and other paperwork as required by the Physician Assistant Program.

Attend all educational conferences/meetings/lectures offered by the clinical site and/or preceptor

when possible.

Participate in after-hour call if available

If possible the student should perform the following procedures:

- Phlebotomy / IV placement

- Endotracheal intubation

- Surgical scrub and gowning / gloving procedures

- Suturing

- Arterial Blood Gas sampling

- Foley catheter placement

- Local and regional anesthesia blocks

- Incision and drainage of abscesses

- Nasogastric intubation

- Fracture splinting

- Therapeutic and diagnostic injections

- Participate in trauma and cardiac codes

- Wound irrigation

Upon completion of the emergency medicine clinical rotation the student will be able to:

- Summarize the fundamentals of wound care and wound healing. Explain how co-morbidities

may affect healing time and change wound management

- Recommend common suture materials and wound closure materials (stainless steel wire, cat-

gut, silk, synthetic non-absorbable, synthetic absorbable, tapes, staples and glues) and their

appropriate use sites.

- Apply common types of stitches including simple interrupted, simple running, running lock-

ing, subcuticular, vertical mattress, horizontal mattress, and purse string stitch

- Asses and judge acute clinical emergencies versus non-emergency diagnoses

101

- Manage shock, its etiology, presentation and treatment

- Define hemorrhagic shock in terms of its quantification in classes and treatments according to

those classifications

- Choose a trauma panel of laboratory studies

- Interpret x-ray findings associated with injury to the thoracic aorta

- Define and apply Glasgow Coma Scale scores, their meaning and prognostic value

- Describe and manage the mechanisms by which CNS trauma causes altered consciousness

- Describe burn body area assessment by the Rule of Nines

- Assess and manage environmental emergencies such as hypothermia and hyperthermia

- Recognize primary pathogens & application of treatment for bites: spider, cat, dog, and hu-

man

- Apply treatment of drug overdose for narcotics, tricyclic antidepressants, and acetaminophen

(Tylenol)

- Formulate emergency management of patients who have been exposed to or ingested poisons.

Include symptoms, antidotes, and other treatments or procedures. Specifically discuss the

following poisons or drugs:

• Atropine & Anticholinergics

• Beta Blockers

• Calcium channel blockers

• Carbon Monoxide

• Chemical Warfare Agents

• Chlorinated Insecticides

• Cocaine

• Cyanide

• Digitalis

• Ethanol, Barbiturates, Benzodi-

azepines

• Gamma Hydroxybutyrate

• Iron

• Lead

• LSD

• Mercury

• Methanol & Ethylene Glycol

• Monoamine oxidase inhibitors

• Opioids

• Pesticides: cholinesterase

inhibitors

• Salicylates

• Tricyclic Antidepressants

- Discuss the indications, contraindications, and risks of the following emergency procedures:

Tracheal Intubation

Cricothyroidotomy

Pneumatic Antishock Garment use

Needle thoracentesis:

o Pericardiocentesis

o Tube thoracostomy

o Peritoneal Lavage

- Recognize and manage the etiology, epidemiology, signs and symptoms, associated appropri-

ate diagnostic studies, differential diagnosis, treatments, and prognosis for the below-listed

problem/disease states:

Rapidly Fatal Thoracic Injuries:

o Airway Obstruction

o Open Pneumothorax

o Tension Pneumothorax

o Cardiac Tamponade

o Massive hemothorax

o Flail Chest

102

Potentially Fatal Thoracic Injuries:

o Pulmonary Contusion

o Traumatic Aortic Rupture

o Injuries to Tracheobronchial Tree

o Myocardial Contusion

o Esophageal injury

o Traumatic Diaphragmatic hernia

Non-life-threatening Thoracic Injuries

o Simple pneumothorax

o Non-massive hemothorax

o Rib fractures

Extremity Trauma

o Crush injuries

o Compartment syndromes

o Traumatic amputation

o Open fractures

o Tetanus Prophylaxis

Burns

o Inhalation injury

o Chemical burns

o Electrical burns

o Special considerations : sepsis, fluid regulation, temperature regula-

tion

Upon completion of the emergency medicine clinical rotation the student will be expected to

demonstrate basic knowledge of the following:

Cardiovascular System

Conduction Disorders

Atrial fibrillation/flutter

Atrioventricular block

Bundle branch block

Paroxysmal supraventricular tachycardia

Premature beats

Ventricular tachycardia

Ventricular fibrillation/flutter

Hypotension

Cardiogenic shock

Orthostasis/postural

Ischemic Heart Disease

Acute myocardial infarction

Vascular Disease

Phlebitis/thrombophlebitis

Venous thrombosis

Syncope

Heart failure

Hypertensive emergencies

Angina pectoris

Unstable angina

Aortic aneurysm/dissection

Aortic stenosis/regurgitation

Mitral stenosis/regurgitation

Acute/subacute bacterial endocarditis

Cardiac tamponade

Pericardial effusion

Pleural Diseases

Pleural effusion

Pneumothorax

• Primary

• Secondary

Pulmonary Circulation

Pulmonary embolism

Hemoptypsis

Acute bronchitis

Acute bronchiolitis

Respiratory syncytial virus

Pneumonia (bacterial, viral, fungal, HIV)

Acute epiglottitis

Croup

Influenza

Pertussis

Acute respiratory distress syndrome

Foreign body aspiration

103

EENT (Eyes, Ears, Nose and Throat)

Eye Disorders

• Blowout fracture

• Corneal abrasion

• Foreign body

• Glaucoma

• Hyphema

• Retinal vascular occlusion

• Vision loss

• Blepharitis

• Conjunctivitis

• Dacryoadenitis

• Macular degeneration

• Optic neuritis

• Orbital cellulitis

• Papilldema

• Retinal detachment

Ear Disorders

• Barotrauma

• Otitis externa/media

• Trauma/ hematoma to ear

• Labrynthitis

• Mastoiditis

• Tympanic membrane perforation

Nose/Sinus Disorders

• Epistaxis

• Acute sinusitis

• Foreign body

Mouth/Throat Disorders

• Dental abscess

• Pharyngitis

• Peritonsillar abscess

• Acute laryngitis

• Epiglottis

Gastrointestinal System/Nutrition

Esophagus

Mallory-Weiss tear

Hematemesis

Jaundice

Melena, hematochezia

Change in bowel habits; diarrhea,

Constipation

Esophagitis

Peptic ulcer disease

Acute cholecystitis

Cholangitis

Acute hepatitis

Acute pancreatitis

Acute appendicitis

Diverticular disease

Ischemic bowel disease

Inflammatory bowel disease

Toxic megacolon

Obstruction (small bowel, large bowel,

volvulus)

Anal fissure/ fistula/ abscess

Hemorrhoids (thrombosed)

Hernia (incarcerated/strangulated)

Infectious diarrhea

Genitourinary System

Benign Conditions of the GU Tract

Nephro/urolithiasis

Infectious/Inflammatory Conditions

Pyelonephritis

Electrolyte and Acid/Base Disorders

Volume depletion

Volume excess

Incontinence

Testicular torsion

Cystitis

Epididymitis

Orchitis

Urethritis

Acute renal failure

Glomerulonephritis

Reproductive System

Pelvic Inflammatory Disease

Ovarian cysts

Dysmenorrhea

Amenorrhea

Endometriosis

Vaginitis

Mastitis/breast abscess

Spontaneous abortion

Abruption placenta

Ectopic pregnancy

Placenta previa

Premature rupture of membranes

Fetal distress

Musculoskeletal System

Fractures/dislocations (shoulder, forearm,

wrist, hand, hip, knee, ankle, foot)

• Boxer's

• Colles'

• Gamekeeper's thumb

• Humeral

• Scaphoid

104

Shoulder Separations

Sprain/strain

Soft tissue injuries

Low back pain

Cauda equine

Herniated disc

Osteomyelitis

Septic arthritis

Neurologic System

Diseases of Peripheral Nerves

• Paresthesias

• Weakness

• Paralysis

• numbness

Bell's palsy

Loss of consciousness

Change in mental status

Loss of memory

Headache (cluster, migraine, tension)

Subarachnoid hemorrhage

Cerebral aneurysm

Intracranial hemorrhage

Coma

Head trauma/concussion/contusion

Epidural/subdural hematoma

Encephalitis

Meningitis

Multiple Sclerosis

Seizure Disorders

Status epilepticus

Vascular Diseases

Stroke

Syncope

Transient ischemic attack

Vertigo

Guillain-Barré syndrome

Spinal cord injury

Hematologic System

Aplastic anemia

Hemolytic anemia

Sickle cell anemia/ crisis

Clotting factor disorders

Hypercoagulable states

Thrombocytopenia

Acute leukemia

Endocrinology

Hyperparathyroidism

Hyperthyroidism

Thyroiditis

Adrenal insufficiency

Diabetes insipidus

Diabetic ketoacidosis

Non-ketotichyperglycemia

Psychiatry/Behavioral Science

Thought disorders

Changes in mood

Hallucinations

Suicidal/homicidal ideations/attempt

Depression

Generalized anxiety disorder

Panic disorder

PTSD

Substance abuse disorder

Child/elder abuse

Domestic violence

Dermatologic System

Papulosquamous Diseases

Drug eruptions

Bacterial Infections

Cellulitis/vasculitis

Erysipelas

Dermatitis (eczema, contact)

Burns

Urticaria

Insects/Parasites-Spider bites

Steven-Johnson syndrome

Toxic epidermal necrolysis

Bullous pemphigoid

Lice

Scabies

Herpes zoster

Impetigo

Pilonidal cyst

Pressure sores

Infectious Diseases

Bacterial Disease

Botulism

Diphtheria

Gonococcal infections

Tetanus

Viral Disease

Rabies

105

RESEARCH MEDICINE Physician Assistant 610 Research Medicine

Credits

2 Semester Hours

Catalog Description

The four-week rotation provides practical clinical experience in clinical research medicine.

Prerequisites/Co-requisites (if applicable)

Admission to the clinical year of the program

Curriculum Goals Addressed by the Course

Goal 1. To learn about research design, hypothesis generation, and the development of research ques-

tions/problem formulation.

Goal 2. To learn to access, assimilate, and critically evaluate the medical literature pertaining to the re-

search topic.

Goal 3. To learn about research ethics, informed consent, and the regulatory processes that must be fol-

lowed in the conduct of research - as appropriate to the project.

Goal 4. To learn about statistics and data analysis - as appropriate to the project.

Goal 5. To conduct research and acquire any skills needed to do so (e.g. laboratory techniques, computer

skills).

Goal 6. To gather data for the project, interpret the data, and integrate the data with information obtained

from the literature review.

Goal 7. To write a report about the research project at the end of the elective

Course Objectives

Upon completion of this supervised clinical practice experience, the learner will:

Create a safe working environment that minimizes risk to patients, self, and others

Exhibit professional behavior during all supervised clinical practice activities

Communicate verbally and nonverbally with others in an appropriate and timely manner

Demonstrate a systematic understanding of formulating a clinical research question

Critically evaluate the phases of clinical trial activity and their order of conduct

Critically appraise the history of and landmark examples of clinical research and debate their impact

on evaluation of clinical research

106

Demonstrate a critical comprehension of the roles and responsibilities of the clinical research team

and evaluate the characteristics and skills required to successfully perform each function

Systematically evaluate research objectives and outcomes and propose and defend their appropriate-

ness to the design stage

Apply current research to support clinical decisions

Document patient encounters in electronic database program

Submit weekly reports and other paperwork, as required

Perform at designated times during the supervised clinical practice experience a self-assessment of

skills required to function in the role of physician assistant in the clinical setting, in order to identify

strengths and weaknesses

Develop a plan to address deficits identified in self-assessment, with provider supervision

Assessment of Course Objectives

Research Report

The student will write a report that documents the research project that they were participating in during

this experience. Using the format below the student will document the following elements of the research

project. Depending upon the research design not all elements below may be covered. The student is en-

couraged to adapt this report according to the research methodology.. In the sample table of contents are

the subheadings that should be used in order. In some proposals not all subheadings may be used. The

manuscript should be written according to APA 5th/6

th edition or AMA style. The cover page for the paper

should follow the attached model. The length of this paper is not predetermined but the student must ad-

dress the important elements of the clinical research project or be deemed inadequate. Student is to use all

resources available to draft this document. A copy of the institutions IRB with the elements of the re-

search project or documents taken directly from a grant will not be accepted. This must be in the student's

own words.

SUGGESTED FORMAT – (NOT ALL REQUIRED)

Section

I. Introduction _ _ _ _ _ _ _ _ _

Background to the problem _ _ _ _ _ _ _ _ _ _

Statement of the problem _ _ _ _ _ _ _ _ _ _ _

Purpose of the study _ _ _ _ _ _ _ _ _ _ _ _ _ _

Research questions _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Rationale for the study _ _ _ _ _ _ _ _ _ _ _ _ _

Importance/significance of the study _ _ _ _ _ _

Definitions _ _ _ _ _ _ _ _ _ _ _ _ _

Limitations of the study _ _ _ _ _ _ _ _ _

107

II. Review of Literature

Provide a brief review of appropriate citations utilized in this study. This may be obtained

from the grant application or other institutional documents. In your own words provide a re-

view of literature that provides a conceptual framework for the study.

III. Methodology and Procedures

Description of population and sample _ _ _ _ _ _ _

Identification of the independent and dependent variables and statement of the research hy-

pothesis _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Instrumentation _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Research design (Procedure for data analysis) _ _ _ _ _ _ _ _

Procedures for data collection _ _ _ _ _ _ _ _ _ _ _ _ _ _

Human subject review clearance _ _ _ _ _ _ _ _ _ _

The final grade for this course will be calculated using the following percentages for each

module:

Final Evaluation from Preceptor 40%

End-of-Rotation Research Report 40%

Professional Seminar Attendance 10%

Required Electronic Entries 10%

Includes weekly reports, student

evaluation of preceptors, and patient

encounters

Total 100%

The criterion for a failing grade for a rotation is any one of the following:

5. Failure to submit written assignments meeting program standards

6. Failing evaluation by the Clinical Preceptor

7. Excessive or unexcused absences from the rotation site

8. Overall rotation grade below 2.0

108

PART III: PREPARING FOR

GRADUATION AND THE PANCE

As graduation approaches, you will have amassed a great deal of

knowledge and skills. The Program uses a variety of means

throughout the course of your education to ensure that you have

achieved the competencies expected of a graduating physician assis-

tant student.

FORMATIVE AND SUMMATIVE EVALUATIONS

STANDARD C3.04 The program must conduct and document a summative evaluation of each

student within the final four months of the program to verify that each student is prepared to en-

ter clinical practice.

FORMATIVE EVALUATION

Formative Evaluation of students is a multi-step process which begins at the mid-point of the 2nd

year:

1. SUMM I: 360 multiple-choice questions, board-style simulation examination based on

the NCCPA Content Blueprint. This examination tests the student’s knowledge base in

all organ systems. After completion, students will receive a detailed report showing their

strengths and weaknesses. Students will be able to discuss with their advisors a study

strategy that students can pursue over the summer to prepare for the second year and the

PANCE evaluation.

2. Physician Assistant Competencies: A Self Evaluation Tool (see Appendix P): The public

demand for higher quality and greater accountability in health care has been growing

steadily over the last several years, and various health care professions are responding in

109

different ways. To address that issue within the PA profession, the PAEA, ARC-PA,

NCCPA, and AAPA, joined together to define PA competencies, a critical starting point

to identify opportunities for improvement in the development and assessment of those

competencies. The four organizations involved in the development of the seminal docu-

ment, Competencies for the Physician Assistant Profession, have developed this self-

evaluation tool to help individual PAs identify areas of personal strength and opportuni-

ties for personal growth, which you may use to guide future CME activities, on-the-job

training, or other self-improvement activities. Students will complete this document and

review it with their advisor at the end of the 1st year and again at the end of the 2

nd year to

show progress.

SUMMATIVE EVALUATION

Summative Evaluation in the 2nd year occurs by utilizing five tools:

1. Spring Semester, 2nd

Year: PACKRAT (Physician Assistant Clinical Knowledge Rating

and Assessment Tool) examination is a self-assessment tool administered at the end of

the clinical year and is a requirement for graduation. The results of the examination pro-

vide students with a report of their areas of strength and areas for improvement. This re-

port may be utilized in formulating study plans for success in the PANCE examination.

The examination report also allows the program to compare student performance with na-

tional scores. Cost of the examination is the responsibility of the student.

2. Spring Semester, 2nd

Year OSCE: This hands-on examination is designed specifically to

test the PA student’s clinical competence.

3. Summer Semester, 2nd

Year: SUMM II is 700 question multiple-choice examinations

given over 2 days. This examination tests the student’s knowledge base for all organ sys-

tems. Students will be able to meet with their advisor and discuss a study strategy that

students can pursue to prepare for the PANCE.

4. Summer Semester, 2nd

Year: Physician Assistant Competencies: Self Evaluation will be

completed and reviewed by students with their advisor at the end of the clinical year.

5. Summer Semester, 2nd

Year: Summative Professionalism Assessment Tool (see Appen-

dix Q). Evaluation of professionalism is an on-going process throughout the program.

Prior to graduation, students and their advisor will complete the summative tool and dis-

cuss their strengths and weakness in this area.

6. To receive passing grades in PA 631/632/633 students must complete all elements of the

Courses; including satisfactory completion of their self-authored clinical vignette and

question portfolio, SUMM I, PACKRAT, SUMM II. The minimum passing score in-

cludes a score of:

110

SUMM I

SUMM II PACKRAT PANCE Predicted

Score

216.19 513.28 138.45 458.25

Any student who scores below the above benchmarks will be required to sign a student study contract. A copy of his contract is provided in Appendix R. These benchmarks were statistically derived from a cohort of students who scored between 350-500 on the PANCE. Because this is considered the highest risk range based on retrospective study. However any student that receives a predicted score of less than 458 and below the benchmarks above on the SUMM I, SUMM II, and PACKRAT is required to schedule an appointment with your advisor to discuss the study contract and sign this agreement. If the student does not under-go the required mentoring session they will receive an Incomplete in the course which can only be removed by completing this requirement.

No student will be eligible for graduation until he or she has

completed the remediation study program.

MSPAS PROGRAM GRADUATION COMPETENCIES

These competencies outline the expected outcomes for MSPAS graduates from Misericordia

University. These outcomes or program graduation competencies are endorsed by the NCCPA,

AAPA, and PAEA to guide PA programs in modifying and improving their curricula. All di-

dactic and clinical experiences contribute cumulatively to these outcomes. Upon graduation, stu-

dents must successfully complete the NCCPA certifying examination in order to practice in all

states. The NCCPA blueprint outlines the required knowledge and skills areas as well as the list

of diseases and disorders to help guide the student toward successful completion of the program

and the certifying examination.

Any PA program can be challenging at times. During those times, the PA faculty and staff sug-

gest that you refer to the program outcomes, required knowledge/skill areas, and disease and dis-

order list to help keep you focused on the final goal. Mastery of these areas will be gradual and

will not occur with any single examination, course, or rotation. It is a process that takes time,

study, and effort. There are several instruments used to measure acquisition and achievement of

these competencies, including preceptor evaluations, graduate exit surveys, and employer sur-

veys. These competencies were adopted by the faculty and staff of the MU PA program to serve

as a roadmap to enter practice as a competent physician assistant.

Medical Knowledge

Medical knowledge includes an understanding of pathophysiology, patient presentation, differen-

tial diagnosis, patient management, surgical principles, health promotion, and disease prevention.

Physician assistants must demonstrate core knowledge about established and evolving biomedi-

cal and clinical sciences and the application of this knowledge to patient care in their area of

111

practice. In addition, physician assistants are expected to demonstrate an investigatory and ana-

lytic thinking approach to clinical situations. Physician assistants are expected to:

• Understand etiologies, risk factors, underlying pathologic process, and epidemiology for

medical conditions

• Identify signs and symptoms of medical conditions

• Select and interpret appropriate diagnostic or laboratory studies

• Manage general medical and surgical conditions to include understanding the indications,

contraindications, side effects, interactions, and adverse reactions of pharmacologic

agents and other relevant treatment modalities

• Identify the appropriate site of care for presenting conditions, including identifying emer-

gent cases and those requiring referral or admission

• Identify appropriate interventions for prevention of conditions

• Identify the appropriate methods to detect conditions in an asymptomatic individual

• Differentiate between the normal and the abnormal in anatomic, physiological, laboratory

findings, and other diagnostic data

• Appropriately use history and physical examination findings and diagnostic studies to

formulate a differential diagnosis

• Provide appropriate care to patients with chronic conditions

Interpersonal & Communication Skills

Interpersonal and communication skills encompass verbal, nonverbal, and written exchanges of

information. Physician assistants must demonstrate interpersonal and communication skills that

result in effective information exchange with patients, their patients’ families, physicians, profes-

sional associates, and the healthcare system. Physician assistants are expected to:

• Use effective listening, nonverbal, explanatory, questioning, and writing skills to elicit

and provide information

• Appropriately adapt communication style and messages to the context of the individual

patient interaction

• Work effectively with physicians and other health care professionals as a member or

leader of a health care team or other professional group

• Apply an understanding of human behavior

112

• Demonstrate emotional resilience and stability, adaptability, flexibility, and tolerance of

ambiguity and anxiety

• Accurately and adequately document and record information regarding the care process

for medical, legal, quality, and financial purposes

Patient Care

Patient care includes age-appropriate assessment, evaluation, and management. Physician assis-

tants must demonstrate care that is effective, patient-centered, timely, efficient, and equitable for

the treatment of health problems and the promotion of wellness. Physician assistants are ex-

pected to:

• Work effectively with physicians and other health care professionals to provide patient-

centered care

• Demonstrate caring and respectful behaviors when interacting with patients and their

families

• Gather essential and accurate information about their patients

• Make informed decisions about diagnostic and therapeutic interventions based on patient

information and preferences, up-to-date scientific evidence, and clinical judgment

• Develop and carry out patient management plans

• Counsel and educate patients and their families

• Competently perform medical and surgical procedures considered essential in the area of

practice

• Provide health care services and education aimed at preventing health problems or main-

taining health

Professionalism

Professionalism is the expression of positive values and ideals as care is delivered. Foremost, it

involves prioritizing the interests of those being served above one’s own. Physician assistants

must know their professional and personal limitations. Professionalism also requires that PAs

practice without impairment from substance abuse, cognitive deficiency, or mental illness. Phy-

sician assistants must demonstrate a high level of responsibility, ethical practice, sensitivity to a

diverse patient population, and adherence to legal and regulatory requirements. Physician assis-

tants are expected to demonstrate:

• Understanding of legal and regulatory requirements, as well as the appropriate role of the

physician assistant

113

• Professional relationships with physician supervisors and other health care providers

• Respect, compassion, and integrity

• Commitment to ethical principles pertaining to provision or withholding of clinical care,

confidentiality of patient information, informed consent, and business practices

• Sensitivity and responsiveness to patients’ culture, age, gender, and disabilities

• Self-reflection, critical curiosity, and initiative

Practice-Based Learning & Improvement

Practice-based learning and improvement includes the processes through which clinicians engage

in critical analysis of their own practice experience, medical literature, and other information re-

sources for the purpose of self-improvement. Physician assistants must be able to assess, evalu-

ate, and improve their patient care practices.

Physician assistants are expected to:

• Locate, appraise, and integrate evidence from scientific studies related to their patients’

health problems

• Apply knowledge of study designs and statistical methods to the appraisal of clinical

studies and other information on diagnostic and therapeutic effectiveness

• Apply information technology to manage information, access online medical information,

and support their own education

Systems-Based Practice

Systems-based practice encompasses the societal, organizational, and economic environments in

which healthcare is delivered. Physician assistants must demonstrate an awareness of, and re-

sponsiveness to, the larger system of health care to provide patient care that is of optimal value.

PAs should work to improve the larger health care system of which their practices are a part.

Physician assistants are expected to:

• Use information technology to support patient care decisions and patient education

• Effectively interact with different types of medical practice and delivery systems

• Understand the funding sources and payment systems that provide coverage for patient

care

• Advocate for quality patient care and assist patients in dealing with system complexities

114

• Apply medical information and clinical data systems to provide more effective, efficient

patient care

PREPARING FOR THE PANCE

The clinical phase of training comes at the end of the MSPAS program, as does studying for the

PANCE. It is difficult to study for the PANCE during rotations, because parallel processes are

occurring: you are acquiring new clinical skills and studying specific topics for the end of rota-

tion examination, while trying to prepare broadly for the PANCE by studying many other diseas-

es perhaps unrelated to your rotation. For this reason, we have attempted to integrate the process

to minimize duplication of study and create synergy. As a result, if you study all the topics we

have listed for each rotation, by the time you finish your rotations, you will have studied all of

the topics on the NCCPA Content Blueprint for PANCE & PANRE (see Appendix E) and will be

thoroughly prepared for the PANCE.

Many questions on the certification (PANCE) examination are drawn from the NCCPA Content

Blueprint. The Content Blueprint contains two helpful documents: the “Content Blueprint Sam-

ple Disease/Disorders by Organ System,” and the “Content Blueprint Physician Assistant Prac-

tice Task Areas.” Both students and faculty use these documents to know which topics are im-

portant and the depth and breadth to which they should be covered.

The organ-system blueprint is a comprehensive list of diseases and disorders commonly encoun-

tered in clinical practice and thus on the certification examinations. The list is arranged by organ

system and also indicates the approximate percentage of questions per organ system that you

may expect on the PANCE (See Appendix E, Table 1). This information is important to consider

when deciding the depth and breadth of study. Because cardiovascular, pulmonary, gastrointesti-

nal/nutritional, and musculoskeletal topics comprise a large portion of the examination (about 48

percent of the questions), faculty and students spend more time on them. Students who have a

poor knowledge base in these four organ systems generally receive poor grades on the PANCE.

The task-areas blueprint is a list of seven main PA knowledge areas that have been identified as

important to clinical practice. It details the cognitive skills and knowledge in each area that stu-

dents must attain for competence. Many of these task areas are covered on the PANCE. Since it

is impossible to study everything about every item in the Content Blueprint, this document helps

you determine what is most important to know.

The task-areas blueprint also indicates the approximate percentage of questions per task you may

expect on the PANCE and PANRE (See Appendix E, Table 2). This is helpful as you begin

studying, so that you can focus your efforts on task areas more commonly seen on the exams.

The organ systems and task areas that are more heavily weighted by the NCCPA receive more

in-depth treatment on the NCCPA examination.

The formulation of a comprehensive and effective study plan requires consideration of many fac-

tors. Haphazard, non-strategic studying that does not take into account the NCCPA Content

Blueprint, the weighting of task areas and organ systems, and your own strengths and weakness-

115

es can lead to disaster. This Rotation Study Program was developed by taking each item on the

“Content Blueprint Sample Disease/Disorders by Organ System” and placing it in the appropri-

ate discipline. For example, it makes sense to include cardiovascular system conduction disor-

ders such as atrial and ventricular blocks in the emergency medicine rotation. Emergency-

oriented eye disorders such as glaucoma also may be found there. You will discover a large

number of organ-system blueprint items in the outpatient medicine and inpatient medicine rota-

tions. This is because there is greater depth and breadth of disorders seen in internal medicine

than in family practice. In the general surgery rotation, items were chosen from the respective

system areas that are most likely to be treated surgically. For example, valvular insufficiencies,

malignancies of the pulmonary system and gastrointestinal system, gallbladder disease, and ap-

pendicitis all may be found in the general surgery chapter.

Because many diseases and disorders can be treated in multiple settings, items repeat across dif-

ferent rotations. While the result is not perfect, considerable effort has been expended to match

the “Content Blueprint Sample Disease/Disorders by Organ System” items to the most appropri-

ate discipline. In addition to testing-specific blueprint topics, there will also be some case-based

questions that are not specifically linked to a blueprint topic, but are discipline related, and will

test knowledge and skills gained at the rotation site.

PA students typically are overwhelmed by the amount of time they must spend at the clinical site

during a rotation, and how little time is left for actual study. Therefore, it is important to set

short-term (daily), intermediate (weekly), and long-term (end-of-rotation) study goals. For ex-

ample, you should calculate how many topics you must cover daily to be ready. As the student,

you must take charge of your learning by determining how you will manage your schedule so

that you are able to complete and study the required topics within the timeframe you have set.

You should also dedicate a few extra days before any testing cycle for review and reinforcement

of materials learned. Because you know how you best learn, taking the time thoughtfully to set a

study schedule is critical.

116

PART IV: ADDITIONAL RESOURCES

ACCREDITATION REVIEW COMMISSION ON EDUCATION FOR THE PHYSICIAN AS-

SISTANT, INC. (ARC-PA)

The Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) is

the recognized accrediting agency that protects the interests of the public and PA profession by

defining the standards for PA education and evaluating PA educational programs within the terri-

torial United States to ensure their compliance with those standards.

The ARC-PA encourages excellence in PA education through its accreditation process, by estab-

lishing and maintaining minimum standards of quality for educational programs. It awards ac-

creditation to programs through a peer review process that includes documentation and periodic

site visit evaluation to substantiate compliance with the Accreditation Standards for Physician

Assistant Education. The accreditation process is designed to encourage sound educational ex-

perimentation and innovation and to stimulate continuous self-study and improvement.

www.arc-pa.org

AMERICAN ACADEMY OF PHYSICIAN ASSISTANTS (AAPA)

The AAPA is the national professional organization of physician assistants. Its membership in-

cludes graduate and student physician assistants as well as affiliate membership for physicians

and physician assistant educators. The Academy provides a wide range of services for its mem-

bers, including representation before federal and state governments and health related organiza-

tions, public education, pamphlets and brochures, insurance and financial programs, and em-

ployment assistance.

117

As an AAPA member, you also receive multiple publications and are entitled to a membership

discount for the annual spring conference. Student Physician Assistant Societies are an integral

part of the AAPA and make up a body referred to as the Student Academy of the American

Academy of Physician Assistants (SAAAPA). The Student Academy meets yearly at the nation-

al spring conference to elect officers and representatives. Release time to attend the national

conference held in May of each year can be requested from the Program and will be allowed on a

case-by-case basis.

The national organization represents you and as such deserves your support during your student

years and as a graduate Physician Assistant. Support for membership in professional organiza-

tions is another benefit also routinely covered by employers.

www.aapa.org

NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS (NCCPA)

All graduates of Physician Assistant Programs accredited by the Accreditation Review Commis-

sion on Education for the Physician Assistant (ARC-PA) are eligible to sit for the national certi-

fying examination (PANCE) offered by the NCCPA.

Registration applications are completed during the senior year of the Physician Assistant Pro-

gram. Most states require graduates to take and successfully pass the national boards to continue

employment. Please refer to the link below for exam scheduling requirements.

Once certified through the NCCPA, each graduate must obtain and report 100 hours of accredit-

ed CME every two years. Recertification examinations are also required every six years, in addi-

tion to the CME requirement.

www.nccpa.net

PENNSYLVANIA SOCIETY OF PHYSICIAN ASSISTANATS (PSPA)

The Pennsylvania Society of Physician Assistants (PSPA) was established in 1976. As a growing

nonprofit organization, the PSPA strives to be representative of all physician assistants within the

Commonwealth of Pennsylvania.

The goals and objectives of the Society are to enhance quality medical care to the people of

Pennsylvania through a process of continuing medical education, both to the membership and to

the public; to provide loyal and honest service to the public and to the medical profession; to

promote professionalism among its membership; and to promote understanding of the PA profes-

sion.

The PSPA is a constituent chapter of the American Academy of Physician Assistants (AAPA).

The Society sends delegates to the AAPA House of Delegates which meets annually to perform

policy making activities under the Academy's bylaws.

www.pspa.net

118

PART V: APPENDICES

This section contains examples of forms that you will use frequently

during your time with us.

119

APPENDIX A

STUDENT HANDBOOK AND POLICY MANUAL

RECEIPT AND ACKNOWLEDGMENT

I acknowledge that I have received and read the 2012-2013 Physi-

cian Assistant Program Policy Manual. I have had an opportunity to

have any questions answered with regard to its content. I agree to abide

by the policies and procedures contained therein.

I have been made aware that, as a student enrolled in a Misericor-

dia University program, I am required to comply with the University's

policies on Health and Immunization and Student Health Insurance.

I have also been made aware that I am bound by policies and pro-

cedures contained in the Misericordia University Student Handbook and

University Catalogue.

________________________________

Print Name

________________________________ ____________

Signature Date

120

APPENDIX B

Department of Physician Assistant

Contact List

Dean, School of Arts and Sciences

Russ Pottle, Ph.D.; MER 329; ext. 1484 rpottle@misericordia.edu

Program Chair/Director Medical Director

Scott L. Massey, Ph.D., PA-C; SCI 119 ; ext. 3047 smassey@misericordia.edu

Stanley J. Dudrick, MD, FAS, SCI 117A; ext. 3064 sdudrick@misericordia.edu

Principal Faculty

Darci Brown, MSPAS, PA-C, Director of Clinical Education

dbrown@misericordia.edu SCI 121, ext. 3061

Abigail Davis, MPAS, PA-C, Director of Didactic Education

adavis@misericordia.edu SCI 116A, ext. 6733

Department Administrative Assistants

Kathryn Michael kmichael@misericordia.edu SCI 112; ext 6716

Diane Hopkins; MER 314; ext. 8184 Helen Bogdon; SCI 203; ext. 6378

Clinical Site Visitors

121

APPENDIX C

Mid-Semester

Advisement Sheet: Fall 2012

Student: ________________________________________ Date:_____________________

General Information

How do you feel about your performance in the program so far?

What do you feel has been your greatest strength?

What has been your greatest weakness?

Coursework

Course Projected Grade

Comments

How your stress is level related to school?

How is your stress level apart from school?

Describe your study habits.

122

How many hours per day do you usually study?

How happy are you with your study habits?

Is there anything else that is important to you that your faculty advisor should know?

_____________________________________________ __________________

Signature Date

Faculty Notes/Follow Up:

123

APPENDIX D

Professional Development

Assessment Tool

Assessment Category

Alw

ays

Usu

ally

Occ

asio

nal

ly

Sel

do

m

No

t A

pp

li-

cab

le

General Does the student exhibit a positive and professional attitude?

4 3 2 1 N/A

Does the student exhibit emotional stability, maturity, empathy, and phys-

ical and mental stamina? 4 3 2 1 N/A

Does the student maintain current immunizations, CPR, and background

checks? 4 3 2 1 N/A

Does the student act appropriately in stressful situations? 4 3 2 1 N/A

Did the student report any physical handicap or health issues that may

affect his/her ability to provide safe, effective medical care? 4 3 2 1 N/A

Professional

Does the student show respect for other students and faculty members? 4 3 2 1 N/A

Does the student comply with dress codes on campus and/or clinical

sites? 4 3 2 1 N/A

Is the student and on time for classes and clinical rotations? 4 3 2 1 N/A

Does the student exhibit unprofessional behavior (including unnecessary

conversations in class during lectures or laboratory sessions)? 4 3 2 1 N/A

Is the student able to work cooperatively, promoting and preserving rela-

tionships with peers and other members of the health care team? 4 3 2 1 N/A

Academic

Does the student demonstrate ability to learn and function in a wide

variety of didactic and clinical settings? This includes demonstrat-

ing cognitive abilities necessary to master relevant content in basic

science and clinical courses to provide the standard of care.

4 3 2 1 N/A

Is there evidence that the student can communicate effectively, both

verbally and written, using appropriate grammar, spelling, and vo-

cabulary?

4 3 2 1 N/A

124

Does the student exhibit academic integrity? 4 3 2 1 N/A

Does the student demonstrate adaptability relative to changing situ-

ations, environments, and new information? 4 3 2 1 N/A

Clinical

Does the student protect the patient’s safety and promote the pa-

tient’s well-being? 4 3 2 1 N/A

Does the student uphold ethical standards for health care? 4 3 2 1 N/A

Does the student provide competent medical care and extend to

each patient the full measure of professional ability as a dedicated,

empathetic student healthcare provider during clinical rotations?

4 3 2 1 N/A

Does the student provide competent medical care under the supervi-

sion of an assigned preceptor? 4 3 2 1 N/A

Does the student demonstrate the ability to learn and function in a

wide variety of clinical settings? 4 3 2 1 N/A

Comments

Faculty Signature Date

Student Signature Date

125

APPENDIX E

NCCPA Content Blueprint

for PANCE & PANRE

Table 1: PANCE Organ System Breakdown

Organ System Exam Content (%)

Cardiovascular 16

Pulmonary 12

Endocrine 6

EENT 9

Gastrointestinal/Nutritional 10

Genitourinary 6

Musculoskeletal 10

Reproductive 8

Neurologic 6

Psychiatry/Behavioral 6

Dermatologic 5

Hematologic 3

Infectious Disease 3

Table 2: PANCE Exam Content by Task Area

Task Area Exam Content (%)

History-taking and performing physical examinations 16

Using laboratory and diagnostic studies 14

Formulating most likely diagnosis 18

Health maintenance 10

Clinical interventions 14

Pharmaceutical therapeutics 18

Applying basic science concepts 10

Tables 1 and 2 are adapted from the National Commission on Certification of Physician Assis-

tants: NCCPA-Connect. http://www.nccpa.net/EX_knowledge.aspx?r=pance. Accessed June 29,

2009.

126

PANCE Content Blueprint

Cardiovascular System

Cardiomyopathy

Dilated

Hypertrophic

Restrictive

Conduction Disorders

Atrial fibrillation/flutter

Atrioventricular block

Bundle branch block

Paroxysmal supraventricular tachycardia

Premature beats

Ventricular tachycardia

Ventricular fibrillation/flutter

Congenital Heart Disease

Atrial septal defect

Coarctation of aorta

Patent ductus arteriosus

Tetralogy of Fallot

Ventricular septal defect

Congestive Heart Failure

Hypertension

Essential

Secondary

Malignant

Hypotension

Cardiogenic shock

Orthostasis/postural

Ischemic Heart Disease

Acute myocardial infarction

Angina pectoris

• Stable

• Unstable

• Prinzmetal's/variant

Vascular Disease

Acute rheumatic fever

Aortic aneurysm/dissection

Arterial embolism/thrombosis

Chronic/acute arterial occlusion

Giant cell arteritis

Peripheral vascular disease

Phlebitis/thrombophlebitis

Venous thrombosis

Varicose veins

Valvular Disease

Aortic stenosis/insufficiency

Mitral stenosis/insufficiency

Mitral valve prolapsed

Tricuspid stenosis/insufficiency

Pulmonary stenosis/insufficiency

Other Forms of Heart Disease

Acute and subacute bacterial endocarditis

Acute pericarditis

Cardiac tamponade

Pericardial effusion

Pulmonary System

Infectious Disorders

Acute bronchitis

Acute bronchiolitis

Acute epiglottitis

Croup

Influenza

Pertussis

Pneumonias

• Bacterial

• Viral

• Fungal

• HIV-related

Respiratory syncytial virus infection

Tuberculosis

Neoplastic Disease

Bronchogenic carcinoma

Carcinoid tumors

Metastatic tumors

Pulmonary nodules

Obstructive Pulmonary Disease

Asthma

Bronchiectasis

Chronic bronchitis

Cystic fibrosis

Emphysema

Pleural Diseases

Pleural effusion

Pneumothorax

• Primary

• Secondary

• Traumatic

• Tension

Vascular Disease

Acute rheumatic fever

Aortic aneurysm/dissection

Arterial embolism/thrombosis

Chronic/acute arterial occlusion

Giant cell arteritis

Peripheral vascular disease

Phlebitis/thrombophlebitis

Venous thrombosis

Varicose veins

Valvular Disease

Aortic stenosis/insufficiency

Mitral stenosis/insufficiency

Mitral valve prolapsed

Tricuspid stenosis/insufficiency

Pulmonary stenosis/insufficiency

Other Forms of Heart Disease

Acute and subacute bacterial endocarditis

Acute pericarditis

Cardiac tamponade

Pericardial effusion

127

Endocrine System

Diseases of the Thyroid Gland

Hyperparathyroidism

Hypoparathyroidism

Hyperthyroidism

Hypothyroidism

Thyroiditis

Neoplastic disease

Diseases of the Adrenal Glands

Cushing's syndrome

Corticoadrenal insufficiency

Diseases of the Pituitary Gland

Acromegaly/gigantism

Dwarfism

Diabetes insipidus

Diabetes Mellitus

Type 1

Type 2

Hypoglycemia

Lipid Disorders

Hypercholesterolemia

Hypertriglyceridemia

EENT

Eye Disorders

Blepharitis

Blowout fracture

Cataract

Chalazion

Conjunctivitis

Corneal abrasion

Dacryoadenitis

Ectropion

Entropion

Foreign body

Glaucoma

Hordeolum

Hyphema

Macular degeneration

Orbital cellulitis

Pterygium

Retinal detachment

Retinal vascular occlusion

Retinopathy

• Diabetic

• Hypertensive

Strabismus

Ear Disorders

Acute/chronic otitis media

Barotrauma

Cerumen impaction

Hearing impairment

Mastoiditis

Meniere's disease

Labyrinthitis

Otitis externa

Tympanic membrane perforation

Vertigo

Nose/Sinus Disorders

Acute/chronic sinusitis

Allergic rhinitis

Epistaxis

Nasal polyps

Mouth/Throat Disorders

Acute pharyngitis

Acute tonsillitis

Aphthous ulcers

Dental abscess

Epiglottitis

Laryngitis

Oral candidiasis

Oral herpes simplex

Oral leukoplakia

Peritonsillar abscess

Parotitis

Sialadenitis

Neurologic System

Alzheimer's Disease

Cerebral Palsy

Diseases of Peripheral Nerves

Bell's palsy

Diabetic peripheral neuropathy

Guillain-Barre syndrome

Myasthenia gravis

Headaches

Cluster headache

Migraine

Tension headache

Infectious Disorders

Encephalitis

Meningitis

Movement Disorders

Essential tremor

Huntington's disease

Parkinson's disease

Multiple Sclerosis

Seizure Disorders

Generalized convulsive disorder

Generalized nonconvulsive disorder

Status epilepticus

Vascular Diseases

Cerebral aneurysm

Stroke

Transient ischemic attack

128

Gastrointestinal System/Nutrition

Esophagus

Esophagitis

Motor disorders

Mallory-Weiss tear

Neoplasms

Strictures

Varices

Stomach

Gastroesophageal reflux disease

Gastritis

Neoplasms

Peptic ulcer disease

Pyloric stenosis

Gallbladder

Acute/chronic cholecystitis

Cholelithiasis

Liver

Acute/chronic hepatitis

Cirrhosis

Neoplasms

Pancreas

Acute/chronic pancreatitis

Neoplasms

Small Intestine/Colon

Appendicitis

Constipation

Diverticular disease

Inflammatory bowel disease

Intussusception

Irritable bowel syndrome

Ischemic bowel disease

Neoplasms

Obstruction

Toxic megacolon

Rectum Anal fissure

Anorectal abscess/fistula

Fecal impaction

Hemorrhoids

Neoplasms

Pilonidal disease

Polyps

Hernia

Hiatal

Incisional

Inguinal

Umbilical

Ventral

Infectious Diarrhea

Nutritional Deficiencies

Niacin

Thiamine

Vitamin A

Riboflavin

Vitamin C

Vitamin D

Vitamin K

Metabolic Disorders

Lactose intolerance

Phenylketonuria

Genitourinary System

Benign Conditions of the GU Tract

Benign prostatic hyperplasia

Cryptorchidism

Erectile dysfunction

Hydrocele/varicocele

Incontinence

Nephro/urolithiasis

Paraphimosis/phimosis

Testicular torsion

Infectious/Inflammatory Con-

ditions Cystitis

Epididymitis

Orchitis

Prostatitis

Pyelonephritis

Urethritis

Neoplastic Diseases

Bladder carcinoma

Prostate carcinoma

Renal cell carcinoma

Testicular carcinoma

Wilms' tumor

Renal Diseases

Acute/chronic renal failure

Glomerulonephritis

Nephrotic syndrome

Polycystic kidney disease

Electrolyte and Acid/Base Disorders

Hypo/hypernatremia

Hypo/hyperkalemia

Hypo/hypercalcemia

Hypomagnesemia

Metabolic alkalosis/acidosis

Respiratory alkalosis/acidosis

Volume depletion

Volume excess

129

Reproductive System

Uterus Dysfunctional uterine bleeding

Endometrial cancer

Endometriosis/adenomyosis

Leiomyoma

Metritis

Prolapse

Ovary

Cysts

Neoplasms

Cervix

Carcinoma

Cervicitis

Dysplasia

Incompetent

Vagina/Vulva

Cystocele

Neoplasm

Rectocele

Vaginitis

Menstrual Disorders

Amenorrhea

Dysmenorrhea

Premenstrual syndrome

Menopause

Breast

Abscess

Carcinoma

Fibroadenoma

Fibrocystic disease

Mastitis

Pelvic Inflammatory Disease

Contraceptive Methods

Infertility

Uncomplicated Pregnancy

Prenatal diagnosis/care

Normal labor/delivery

Complicated Pregnancy

Abortion

Abruptio placenta

Dystocia

Ectopic pregnancy

Fetal distress

Gestational diabetes

Gestational trophoblastic disease

Molar pregnancy

Multiple gestation

Placenta previa

Postpartum hemorrhage

Pregnancy-induced hypertension

Premature rupture of membranes

Rh incompatibility

Musculoskeletal System

Disorders of the Shoulder

Fractures/dislocations

Rotator cuff disorders

Separations

Sprain/strain

Disorders of the Forearm/Wrist/Hand

Fractures/dislocations

• Boxer's

• Colles'

• Gamekeeper's thumb

• Humeral

• Nursemaid's elbow

• Scaphoid

Sprains/strains

Tenosynovitis

• Carpal tunnel syndrome

• de Quervain's tenosynovitis

• Elbow tendinitis

• Epicondylitis

Disorders of the Back/Spine

Ankylosing spondylitis

Back strain/sprain

Cauda equina

Herniated nucleus pulposis

Kyphosis/scoliosis

Low back pain

Spinal stenosis

Disorders of the Hip

Aseptic necrosis

Fractures/dislocations

Slipped capital femoral epiphysis

Disorders of the Knee

Bursitis

Fractures/dislocations

Meniscal injuries

Osgood-Schlatter disease

Sprains/strains

Disorders of the Ankle/Foot

Fractures/dislocations

Sprains/strains

Infectious Diseases

Acute/chronic osteomyelitis

Septic arthritis

Neoplastic Disease

Bone cysts/tumors

Ganglion cysts

Osteosarcoma

Osteoarthritis

Osteoporosis

Rheumatologic Conditions

Fibromyalgia

Gout/pseudogout

Juvenile rheumatoid arthritis

Polyarteritis nodosa

Polymyositis

Polymyalgia rheumatic

Reiter's syndrome

Rheumatoid arthritis

Systemic lupus erythematosus

Scleroderma Sjogren's syndrome

130

Psychiatry/Behavioral Science

Anxiety Disorders

Panic disorder

Generalized anxiety disorder

Posttraumatic stress disorder

Phobias

Attention-Deficit Disorder

Autistic Disorder

Eating Disorders

Anorexia nervosa

Bulimia nervosa

Obesity

Mood Disorders

Adjustment

Depressive

Dysthymic

Bipolar

Personality Disorders

Antisocial

Avoidant

Borderline

Histrionic

Narcissistic

Obsessive-compulsive

Paranoid

Schizoid

Schizotypal

Psychoses Delusional disorder

Schizophrenia

Schizoaffective disorder

Somatoform Disorders

Substance Use Disorders

Alcohol abuse/dependence

Drug abuse/dependence

Tobacco use/dependence

Other Behavior/Emotional Disorders

Acute reaction to stress

Child/elder abuse

Domestic violence

Uncomplicated bereavement

Dermatologic System

Eczematous Eruptions

Dermatitis

• Atopic

• Contact

• Diaper

• Nummular eczematous

• Perioral

• Seborrheic

• Stasis

Dyshidrosis

Lichen simplex chronicus

Papulosquamous Diseases

Dermatophyte infections

• Tinea versicolor

• Tinea corporis/pedis

Drug eruptions

Lichen planus

Pityriasis rosea

Psoriasis

Desquamation

Stevens-Johnson syndrome

Toxic epidermal necrolysis

Erythema multiforme

Vesicular Bullae

Bullous pemphigoid

Acneiform Lesions

Acne vulgaris

Rosacea

Folliculitis

Verrucous Lesions

Seborrheic keratosis

Actinic keratosis

Insects/Parasites

Lice

Scabies

Spider bites

Neoplasms

Basal cell carcinoma

Melanoma

Squamous cell carcinoma

Hair and Nails

Alopecia areata

Androgenetic alopecia

Onycomycosis

Paronychia

Viral Diseases

Condyloma acuminatum

Exanthems

Herpes simplex

Molluscum contagiosum

Verrucae

Varicella-zoster virus infections

Bacterial Infections

Cellulitis/vasculitis

Erysipelas

Impetigo

Other

Acanthosis nigricans

Burns

Decubitus ulcers/leg ulcers

Hidradenitis suppurativa

Lipomas/epithelial inclusion cysts

Melasma

Urticaria

Vitiligo

131

Hematologic System

Anemias

Aplastic anemia

Vitamin B12 deficiency

Folate deficiency

Iron deficiency

G6PD deficiency

Hemolytic anemia

Sickle cell anemia

Thalassemia

Coagulation Disorders

Factor VIII disorders

Factor IX disorders

Factor XI disorders

Thrombocytopenia

• Idiopathic thrombocytopenic

purpura

• Thrombotic thrombocytopenic

purpura

• Von Willebrand's disease

Malignancies

Acute/chronic lymphocytic leukemia

Acute/chronic myelogenous leukemia

Lymphoma

Multiple myeloma

Infectious Diseases

Fungal Disease

Candidiasis

Cryptococcosis

Histoplasmosis

Pneumocystis

Bacterial Disease

Botulism

Chlamydia

Cholera

Diphtheria

Gonococcal infections

Salmonellosis

Shigellosis

Tetanus

Mycobacterial Disease

Tuberculosis

Atypical mycobacterial disease

Parasitic Disease

Amebiasis

Hookworms

Malaria

Pinworms

Toxoplasmosis

Spirochetal Disease

Lyme borreliosis

• Lyme disease

Rocky Mountain spotted fever

Syphilis

Viral Disease

Cytomegalovirus infections

Epstein-Barr virus infections

Erythema infectiosum

Herpes simplex

HIV infection

Human papillomavirus infections

Influenza

Mumps

Rabies

Roseola

Rubella

Measles

Varicella-zoster virus infections

132

APPENDIX F

STUDENT ACADEMIC

MENTORING FORM

Student:________________________________________ Date:_____________________

Faculty:_____________________________ Time Start: _____________End: ___________

Mode of Contact:

Student Initiated Faculty Initiated Other: ____________________________

Describe the reason for this encounter:

Academic Remediation Methods Reviewed:

Organization of Notes

Study Strategies

Group Study Plan

Other (see below)

COMMENTS/NOTES:

PLANS and/or REFERRALS TO STUDENT

Referred to Graduate Assistant for

Tutoring

Referred to Disability Services

Referred to Course Coordinator

Referred to Faculty Advisor

Referred to Program Director –

Study Skills

Referred to counseling services

133

FOLLOW-UP SUMMARIES

Date: ___________ Faculty:

Date: ___________ Faculty:

Date: ___________ Faculty:

134

APPENDIX G

STUDENT HEALTH RECORDS & IMMUNIZATIONS

Dear Incoming Student,

In order to meet the accreditation standards of the ARC-PA for the Master of Science in Physi-

cian Assistant degree at Misericordia University, the University has contracted with CERTIPHI

to store, monitor and maintain confidential student health records. CERTIPHI is a confidential

student health record service. CERTIPHI will mail all students the health forms that are required

and must be filled out. Upon receipt of your health forms, CERTIPHI will provide the student

with a membership card which will enable the student to have all the necessary contact infor-

mation as well as their CERTIPHI account number.

Additionally, the student will receive a letter from CERTIPHI indicating compliance with Uni-

versity requirements. It is imperative that the student complete all required health records and

immunization forms prior to matriculation. Failure to provide complete health records may delay

entry or the ability to participate in required clinical rotations.

In addition to storing student health information, CERTIPHI will keep the Director of Clinical

Education at Misericordia University up to date with the status of all student immunizations.

Student health records will not be released without written permission from the student. Health

screening, immunizations and/or healthcare services will not be conducted by program person-

nel.

Health packages include:

Student Health History and Information form

Physical Examination form

Immunization Verification form

Specific health screening and immunization requirements are based on current Centers

for Disease Control Recommendations for health professionals.

Requirements include:

1. Provide proof of personal health insurance throughout the entire program;

2. Provide proof of a satisfactory physical examination;

3. Provide proof of TB Tine Test (positive results will require the student to receive a chest

x-ray and further evaluation);

4. Provide proof of Hepatitis B vaccine and positive Hep B Ab;

5. Provide proof of MMR vaccine or immunity;

6. Provide Varicella history or vaccination.

Health Screening

Requirements

135

7. Tetanus/Diphtheria/Pertussis vaccine

8. Pneumococcal polysaccharide PPV vaccine

9. Drug Screen

Prior to entering the clinical phase of the program, students must again update their immuniza-

tion record and provide proof of the following:

1. Provide proof of current CPR certification;

2. Provide proof of updated annual TB PPD or tine test;

3. Provide proof of blood-borne pathogen orientation course; and

4. Provide proof of current personal health insurance, throughout the clinical year.

5. Background check

6. Satisfactory physical examination

7. Satisfactory drug screen

Note: Health Screening and student immunizations may not be conducted by faculty or staff of

Misericordia University.

Misericordia University student health records are confidential and will not be maintained by, or

accessible to, the physician assistant program faculty or staff except for immunizations and

tuberculosis screening results.

Student health records will not be released without written permission from the student. Health

screening, immunizations, and/or healthcare services will not be conducted by program

personnel.

136

APPENDIX H

Incident

Report

In the event you are injured, your highest priority is prompt treatment. Do not delay seeking ap-

propriate treatment to fill out paperwork or make notifications. Students should comply with all

accident/injury protocols in place at the clinical site. In the absence of a protocol, seek treatment

in the nearest emergency department.

Student Name: ____________________________________________ Date: ________________

Rotation: ______________________________________________________________________

Nature of Incident

Date of Incident: ___________________ Approximate Time of Incident: ________________

Did Incident Involve Possible Exposure to Bloodborne Pathogen? □ No □Yes (see below)

Description of Incident: __________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Actions/First Aid Taken Immediately Following Incident: _______________________________

______________________________________________________________________________

______________________________________________________________________________

Bloodborne Pathogen Exposure

Students who are potentially exposed to bloodborne pathogens should seek prompt evaluation.

Evidence suggests that prophylactic medications are more likely to be effective when taken soon

after an exposure. Students should also consider contacting the National Clinicians’ Post-

Exposure Prophylaxis Hotline: 888-448-4911.

137

Notifications Date and Time Notified

Clinical Preceptor

Onsite Health Services / Employee

Health/Occupational Health

or

Emergency Department

Director of Clinical Education

or

Program Director

_________________________________________________ ________________________ Student Signature Date

Submit this form to the Director of Clinical Education – fax: 570-675-2441

Additional Follow Up / For Program Use

138

APPENDIX I

SITE VISIT EVALUATION

Student: __________________________________________________Date:_______________

Rotation: ________________________________Preceptor: ___________________________

Site / Preceptor Evaluation

Category Yes No N/A

Physical layout of facility is adequate and conducive for learning

Preceptor/facility provides orientation to facility/staff

Preceptor available to meet

Preceptor appears enthusiastic about teaching

Student work hours are appropriate

Student integrated into healthcare team

Site provides appropriate responsibilities

Site allows students to document in chart

Number and diversity of patients provide well-rounded experience

Site provides formal lectures/conferences/teaching rounds

Site provides access to the following educational resources:

□ Medical Library □ Internet □ Formal lectures/conferences/teaching rounds

Inpatient: Number of patients followed by student ______

Outpatient: Approximate number of patients seen by student daily ______

What procedures is student permitted to perform on this site? __________________________________

____________________________________________________________________________________

____________________________________________________________________________________

Comments regarding site: _______________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

139

Student Evaluation

Category Yes No N/A

Student on site

Student readily identifiable as a PA student

Attire / Appearance is appropriate for clinical environment

Able to observe student taking history?

Able to observe student performing physical examination?

Patient Presentation: Ask student to present one or more patients in one or more of the following formats:

Comprehensive Detailed Brief

Complete HPI, PMH, FH, SocH, ROS,

PEX, laboratory studies, assessment,

including differential diagnosis, and

plan.

Relevant features of all elements of

presentation, but able to use terms such

as “noncontributory" or "unremarkable"

for categories. Acceptable to say labora-

tory studies are normal, PE normal ex-

cept for..... Highlights pertinent posi-

tives and negatives; avoids irrelevant

information.

Limited HPI and PMH. Limited Physi-

cal Examination and laboratory stud-

ies. Limited differential diagnosis, as-

sessment, and plan. Certainly no more

than 6 sentences total.

Not to exceed 7 minutes speaking at an

understandable pace.

Not more than 3 minutes.

30 seconds – 1 minute

Assessment Areas Deficien

t

Belo

w

Avera

ge

Avera

ge

Ab

ove

Avera

ge

N/A

Student communicates clearly. 0 2 3 4 N/A

Student able to integrate findings from PE, history and diagnostic stud-

ies. 0 2 3 4 N/A

Student able to articulate a logical differential diagnosis 0 2 3 4 N/A

Student develops management plan that logically follows from differ-

ential diagnosis. 0 2 3 4 N/A

Student shows awareness of preventive/health maintenance concerns. 0 2 3 4 N/A

Student demonstrates sufficient knowledge of patient’s medications,

including classes, indications, contraindications, and potential interac-

tions.

0 2 3 4 N/A

Comments regarding student performance: __________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

____________________________________ ______________________________ _____________ Evaluator Signature Date

140

APPENDIX J

Clinical Rotation Written

History and Physical Examination Student Name: ___________________________________ Date: _________________ Rotation Location and Specialty: ___________________________________________ Case Information Patient Age: ________ Patient Gender: M F Patient Race: _____________ Admission/Visit Date: __________ Date(s) Under Your Care (if different): __________ Presenting Complaint: ___________________________________________________

Primary Diagnosis/Diagnoses ICD Code(s)

Major Procedures Involvement

CPT Code(s) Performed Observed

Clinical Preceptor Certification I certify that the above-named student was substantially involved in the care of the patient indi-cated above and in the attached written history and physical examination report.

Preceptor Name and Title: ________________________________________________ Signature: ______________________________ Date: ________________

141

Evaluation of Written

History and Physical Examination Student Name: ___________________________________ Date: _________________ Rotation Location and Specialty: ___________________________________________ Evaluation of Written H&P Evaluation Instructions: Please carefully read each of the narratives associated with each

of the evaluation criteria found below. After becoming familiar with each of the narratives

assign a numeric rank for the student based on the narrative that best describes the stu-

dent’s level of performance. Once you have assigned a rank to each category, average the

ranks to obtain an overall rating of student performance.

Date/Time/Signature/ID/Source/Reliability/CC

Incomplete or inaccurate with deficiencies throughout.

Incomplete or inaccurate involving no more than 4 items or details.

Incomplete or inaccurate involving no more than 2 items or details.

Complete and accurate with all data presented. Errors in formatting, spelling or abbrevia-tions only.

Complete and accurate with all data presented in the appropri-ate format.

0 2 3 4 5 History of Present Illness (HPI): Content

Incomplete or inconsistent or inaccurate with one or more major details omitted.

One or two details omitted or impertinent ROS included.

All major and minor details presented, but with a substan-tial amount of extraneous information.

All major and minor details presented with a minimal amount of extraneous infor-mation.

Complete, consistent and accurate. All major and minor details presented without any extraneous information.

0 2 3 4 5 History of Present Illness (HPI): Chronology

Fragmented and confusing. Cannot get a clear picture of the sequence of events.

Occasionally fragmented or difficult to follow.

Chronology not entirely clear or understandable as to the sequence of events.

Chronology of events present-ed in a clear, understandable progression. Could be more concise.

Chronology of events present-ed in a clear, understandable, concise progression.

0 2 3 4 5 History of Present Illness (HPI): Organization

Major data items not grouped appropriately. Disorganized throughout.

Three or four minor data items not grouped appropriately. Reader has to look for infor-mation.

One or two minor data items not grouped appropriately.

All data grouped appropriately and presented in an organized, concise manner, in the appro-priate format. Errors with formatting only.

All data grouped appropriately and presented in an organized, concise manner, in the appro-priate format.

0 2 3 4 5 Allergies/ADR’s/Medications

One medication ADR or allergy missing.

All allergies ADR’s and medica-tions present. One or more medications spelled incorrectly AND/OR dose or route or frequency missing for one or more medications.

All allergies ADR’s and medica-tions present and spelled correctly. Dose or route or frequency missing for only one medication.

All allergies ADR’s and medica-tions present. Dose route, frequency included for each medication. One medication spelled incorrectly.

All allergies ADR’s and medica-tions present and spelled correctly. Dose, route, frequency included for each medication.

0 2 3 4 5 Past Medical History (PMH)

Event(s) missing Multiple problems with format AND/OR associated details omitted for multiple events.

All events presented, but associated details omitted for one or two events.

Complete, consistent and accurate with all events pre-sented. Formatting problems only.

Complete, consistent and accurate with all events and associated details presented in the appropriate format.

0 2 3 4 5 Family History (FH)

One pertinent positive illness omitted OR deficiencies throughout the pedigree dia-gram.

One or two pertinent negative illness omitted AND minor inaccuracies on the pedigree diagram. OR family members omitted.

All pertinent positive illnesses presented. One or two pertinent negative illness omitted.

Complete and accurate with all pertinent positive and negative illnesses presented. Minor inaccuracies on the pedigree diagram.

Complete; with all pertinent positive and negative illnesses and pedigree diagram present-ed accurately.

0 2 3 4 5

142

Social History (SH)

Incomplete or inconsistent or inaccurate or with organization-al deficiencies throughout.

One or two required data items omitted AND needs better organization.

One or two required data items omitted.

Complete, consistent and accurate with all required data presented. Needs better organization.

Complete, consistent and accurate with all required data presented in an organized, concise fashion.

0 2 3 4 5 Review of Systems (ROS)

Multiple pertinent negative data AND/OR pertinent positive data item omitted OR data in ROS that belongs in HPI.

Positive data not presented first OR one or two pertinent posi-tive data items omitted.

Consistent and accurate with only one or two pertinent negative data items omitted

Complete, consistent and accurate with all pertinent positive and negative data presented. Errors in formatting only.

Complete and accurate with all pertinent positive and negative data presented in the appropri-ate format.

0 2 3 4 5 Physical Examination (PE)

Incomplete or inconsistent or inaccurate or with organization-al deficiencies throughout.

One or two required data items omitted AND needs better organization.

One or two required data items omitted.

Complete, consistent and accurate with all required data presented. Needs better organization.

Complete, consistent and accurate with all required data presented in an organized, concise fashion.

0 2 3 4 5 Assessment Assessment does not logically follow data obtained from history and examination.

Assessment not comprehen-sive or minor flaws in logical thinking.

Minor flaw in assessment or significant flaw in organization.

Complete and comprehensive, minor flaws in organization.

Completely and logically ad-dresses all issues raised in history and examination.

0 2 3 4 5 Plan

Plan inappropriate, impractical or fails to address significant issue raised in assessment.

Significant problems with organization OR fails to ad-dress minor issue.

Addresses all issues, minor flaws in organization.

Comprehensive but with some impractical choices.

Comprehensive plan which appropriately addresses all issues raised in assessment.

0 2 3 4 5 Mechanics/Medical Terms/Abbreviations Any miscategorization of data. Frequent spelling and/or grammar errors OR frequently fails to use or improperly uses medical terminology and/or abbreviations. Patient identifi-ers not removed.

All information categorized properly. Occasional grammar or spelling errors AND instanc-es of not using or inappropriate use of medical terminology or abbreviations.

All information categorized properly. One or two instances of not using medical terminology and/or abbreviations where appropriate.

All information categorized properly. One or two grammar or spelling errors.

All information categorized properly. No grammar or spelling errors. Appropriate use of medical terminology and abbreviations. Patient identifiers removed.

0 2 3 4 5

Overall Rating of WRITTEN HISTORY AND PHYSICAL EXAMINATION

Take an average of the criteria listed above and circle this result on the top scale provided below.

H&P Score < 1.8 1.8-2.21 2.22-2.59 2.6-2.99 3.0-3.39 3.4-3.79 3.8-4.39 4.4-5.0

Letter Grade F C C+ B- B B+ A- A

Conversion to 4.0 Scale 0 2.0 2.33 2.67 3.0 3.33 3.67 4.0

Comments:

Faculty Advisor: _______________________________________ Date: __________________

143

Appendix K

Evaluation of

Topic Paper Student Name: ____________________________________ Date: _____________ Rotation Location and Specialty: _________________________________________ Topic: ______________________________________________________________

Introduction Does not adequately convey

topic. Does not describe

subtopics to be reviewed.

Lacks adequate thesis state-

ment.

Conveys topic, but not key

question(s). Describes

subtopics to be reviewed.

General thesis statement.

Conveys topic and key ques-

tion(s). Clearly delineates

subtopics to be reviewed.

General thesis statement.

Strong introduction of

topic’s key question(s),

terms. Clearly delineates

subtopics to be reviewed.

Specific thesis statement.

0 2 3 4

Research Inadequate sources

supporting thesis. Sources

insignificant or unsubstanti-

ated.

Sources generally accepta-

ble but not peer-reviewed /

evidence based.

Sources well selected to

support thesis with some

research in support of thesis.

Strong peer reviewed

research based support for

thesis.

0 2 3 4

Conclusion Does not summarize evi-

dence with respect to thesis

statement. Does not discuss

the impact of researched

material on topic.

Review of key conclusions.

Some integration with thesis

statement. Discusses impact

of researched material on

topic.

Strong review of key

conclusions. Strong integra-

tion with thesis statement.

Discusses impact of re-

searched material on topic.

Strong review of key con-

clusions. Strong integration

with thesis statement. In-

sightful discussion of impact

of the researched material

on topic.

0 2 3 4

Grammar and Mechanics Grammatical errors or

spelling & punctuation

substantially detract from

the paper.

Moderate grammatical,

spelling or punctuation er-

rors interfere with reading

the paper.

Grammatical errors or

spelling & punctuation are

rare and do not detract from

the paper.

The paper is free of gram-

matical errors and spelling

& punctuation.

0 2 3 4

144

Style and Communication Errors in AMA style detract

substantially from the paper.

Word choice is informal in

tone. Writing is choppy,

with many awkward or

unclear passages.

Errors in AMA style are

noticeable. Word choice

occasionally informal in

tone. Writing has a few

awkward or unclear passag-

es.

Rare errors in AMA style

that do not detract from the

paper. Scholarly style. Writ-

ing has minimal awkward of

unclear passages.

No errors in AMA style.

Scholarly style. Writing is

flowing and easy to follow.

0 2 3 4

Citations and References Reference and citation errors

detract significantly from

paper.

Two references or citations

missing or incorrectly writ-

ten.

One reference or citation

missing or incorrectly writ-

ten.

All references and citations

are correctly written.

0 2 3 4

Average: _________________

Comments: _________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

______________________________________________ __________________________ Evaluator Date

145

APPENDIX L

Mid-Rotation Evaluation

Student Name:_________________________________________ Rotation Dates:

Clinical Site: _____________________________ Preceptor: ____________________________

STUDENT SELF-ASSESSMENT

Self -Assessment

Ex

cellent

Very

Go

od

Av

erage

Deficien

t

N/A

How do you rate your ability to obtain an appropriate, accurate pa-

tient history?

How do you rate your ability to perform an appropriate, comprehen-

sive physical examination?

How do you rate your ability to present your findings orally to your

preceptor/other clinicians?

How do you rate your ability to formulate a differential diagnosis?

How do you rate your ability to formulate and implement a patient

management plan?

How do you rate your ability to perform clinical procedures appro-

priate to this rotation?

How do you rate your professional behavior on this rotation?

What are your greatest strengths on this rotation?

What improvements do you need to make?

146

PRECEPTOR ASSESSMENT OF STUDENT PERFORMANCE

Student Assessment

Ex

cellent

Very

Go

od

Av

erage

Deficien

t

N/A

How do you rate this student’s ability to obtain an appropriate, accu-

rate patient history?

How do you rate this student’s ability to perform an appropriate,

comprehensive physical examination?

How do you rate this student’s ability to present findings orally to

you as preceptor or to other clinicians?

How do you rate this student’s ability to formulate a differential di-

agnosis?

How do you rate this student’s ability to formulate and implement a

patient management plan?

How do you rate this student’s ability to perform clinical procedures

appropriate to this rotation?

How do you rate this student’s professional behavior on this rota-

tion?

Does this student’s current performance in this rotation merit a passing grade?

____ Yes ____ No _____ Uncertain

What are the most important things this student should do to improve his/her performance?

Additional Comments/Suggestions:

Preceptor’s Signature: _____ Date:

Student’s Signature: _____ Date:

147

APPENDIX M

End of Rotation Evaluation

Preceptor Evaluation Student Name: __________________________________________________ Date: ____________

Rotation: ________________________________________________________________

For each of the following sections, please indicate the degree to which each of the statements is

reflective of student performance. Please use the following scale in your evaluation:

5 Consistently exceeds expectations; outstanding performance

4 Occasionally exceeds expectations; above average performance

3 Meets expectations; average performance

2 Occasionally meets expectations; below average performance

1 Does not meet expectations; poor performance

N/A Not applicable to this clinical experience

Medical Knowledge

Demonstrates appropriate knowledge of disease pathophysiology, clinical presentation, treatment

options, and prognosis.

The student can explain disease etiologies, risk factors, underlying patho-

logic process, and epidemiology for medical conditions.

1 2 3 4 5 NA

The student can describe signs and symptoms for disease states related to

the most frequent presentation for a given disorder.

1 2 3 4 5 NA

The student can form appropriate differential diagnoses during patient

presentations.

1 2 3 4 5 NA

The student can manage general medical and surgical conditions to in-

clude understanding the indications, contraindications, side effects, inter-

actions and adverse reactions of pharmacological agents and other rele-

vant treatment modalities.

1 2 3 4 5 NA

The student can identify the appropriate site of care for presenting condi-

tions, including identifying emergent cases and those requiring referral or

admission.

1 2 3 4 5 NA

The student selects and interprets appropriate diagnostic or laboratory

studies.

1 2 3 4 5 NA

The student can identify appropriate interventions for prevention of path-

ophysiologic conditions.

1 2 3 4 5 NA

148

The student derives sufficient, essential, and accurate history to direct

physical examination and develops appropriate diagnoses. 1 2 3 4 5 NA

Demonstrates ability to use historical information to direct a focused

physical examination. (Evidence: Case presentations to preceptor reflect a

logical connection between historical information and physical examina-

tion findings.)

1 2 3 4 5 NA

Demonstrates knowledge of normal physical examination findings.

1 2 3 4 5 NA

Demonstrates knowledge of abnormal physical examination findings and

their relationship to possible diagnoses. Evidence: Case presentations re-

veal appropriate recognition of findings and incorporation of findings into

assessment and plan.

1 2 3 4 5 NA

Patient Care

The student can develop and carry out patient management plans.

1 2 3 4 5 NA

Demonstrates appropriate physical examination skills. Evidence: Find-

ings are reproducible by preceptor.

1 2 3 4 5 NA

Demonstrates competent performance in medical and surgical procedures

that are considered essential in the area of practice. Evidence: Articulates

completely the steps of a given procedure, materials needed, follow-up

care/patient instructions, possible adverse reactions and contraindications.

1 2 3 4 5 NA

Student demonstrates correct use of instruments, skills in performing pro-

cedures, gives clear instructions to assistants, and maintains calm in the

face of unplanned complications.

1 2 3 4 5 NA

Sets appropriate boundaries for effective patient relationships.

1 2 3 4 5 NA

Counsels and educates patients and their families appropriately.

1 2 3 4 5 NA

Interpersonal and Communication Skills

The student appropriately adapts communication style to the context of all

patient interactions.

1 2 3 4 5 NA

Produces reliably accurate, concise, organized documentation for patient

interactions. Evidence: Documentation demonstrates an accurate record

of patient encounters with attention to legibility, correct physical examina-

tion findings, patient identifiers, logical assessment of case presentation,

clear treatment plans with prescriptions, follow up appointments, consul-

tations, and ensures co-signature of preceptor.

1 2 3 4 5 NA

Documentation demonstrates improvement over the course of the rotation

with regard to physical exam descriptions and economy of words.

1 2 3 4 5 NA

Conducts respectful interviews, with empathy and sensitivity.

1 2 3 4 5 NA

149

Professionalism

Demonstrates a respectful attitude toward, and works appropriately with,

preceptors, staff, and patients at all times.

1 2 3 4 5 NA

Demonstrates timely attendance and appropriate dress, and accomplishes

assigned tasks on time.

1 2 3 4 5 NA

Demonstrates self-directed study.

1 2 3 4 5 NA

Recognizes personal learning needs and limitations and seeks to rectify

them.

1 2 3 4 5 NA

Promptly completes assigned tasks.

1 2 3 4 5 NA

Openly seeks, and positively responds to, constructive criticism from pre-

ceptors and staff.

1 2 3 4 5 NA

Demonstrates the ability to use criticism to change behavior/attitudes.

1 2 3 4 5 NA

Practice-based Learning

Locates, appraises and integrates evidence from scientific studies related

to patients’ health problems.

1 2 3 4 5 NA

Applies knowledge of study designs and statistical methods to the ap-

praisal of clinical studies and other information on diagnostic and thera-

peutic effectiveness.

1 2 3 4 5 NA

Systems-based Learning

Acts as an advocate for patients and their families.

1 2 3 4 5 NA

Applies information technology to manage information; is able to access

online medical information and support didactic and clinical education.

1 2 3 4 5 NA

150

Additional Comments

Please add comments regarding this student’s individual strengths/weakness.

Please add any comments regarding MU PA students in general with regard to weaknesses or

suggestions to improve their preparedness for this rotation.

Preceptor Information

If this form is completed by someone other than the primary preceptor, it must be signed by the

primary preceptor. Please check the item which best describes your knowledge of, and contact

with, this student.

_____ Daily Contact _____Intermittent _____Occasional Contact _____None at All

I have discussed this evaluation with the student. ____ Yes ____ No

I have directly observed the student’s clinical performance. ____ Yes ____No

__________________________________________________ _________________

Evaluator’s Signature and Title Date

__________________________________________________

Primary Preceptor’s Signature (if other than the above)

For PA Program Use Grade

Faculty Initial Student Review Date

151

APPENDIX N

Student Evaluation of

Preceptor/Clinical Site

Student Name: Rotation Dates: ______

Clinical Site:

Name(s) of Preceptor(s):

Preceptor Evaluation

Category

The Clinical Preceptor:

Str

on

gly

Disa

gre

e

Disa

gre

e

Neu

tral

Ag

ree

Str

on

gly

Ag

ree

No

t Ap

pli-

cab

le

Discussed goals and objectives of rotation with me at the

beginning of the rotation.

Was readily available to me.

Set aside time for teaching.

Appeared enthusiastic about teaching and having me as a

student.

Encouraged me to ask questions.

Provided feedback regarding my strengths and weaknesses

in a constructive manner.

Encouraged me to accept appropriate responsibilities in

working with patients.

Provided appropriate supervision during history taking,

physical examinations and procedures.

Encouraged discussion of patient treatment plans.

Assisted me in meeting most of the goals and objectives for

this rotation.

Formally discussed my final evaluation.

Served as a model of the type of healthcare provider I would

like to become.

152

The Clinical Site

Category

The Clinical Site:

Str

on

gly

Disa

gre

e

Disa

gre

e

Neu

tral

Ag

ree

Str

on

gly

Ag

ree

No

t Ap

pli-

cab

le

Provided an orientation to the practice/site.

Incorporated me into the team of healthcare providers.

Administrative and support staff were supportive.

Demonstrated an active interest in medical educa-

tion/teaching.

Provided an adequate opportunity to practice clinical skills.

Provided an adequate patient load (in terms of number and

variety).

Provided access to learning experiences such as lectures,

conferences and teaching rounds.

Provided access to other educational resources, such as a

library or the internet.

Inpatient rotations: Approximately how many patients did you follow on a daily basis? ___

Outpatient rotations: How many patients did you evaluate on an average day? _______

What did you like best about this rotation?

What did you like least about this rotation?

What could be done to enhance this clinical site?

Signature: __________________________________________ Date: _______________

153

APPENDIX O

Oral Presentation

Grading

Student Name: _______________________________________ Date: __________________________

Rotation: ____________________________________________________________________________

Please assess the oral presentation according to the following rubric. Please provide comments for any

area assessed as “unacceptable” or regarded to be a critical omission.

Patient History and Physical Examination

Un

acce

pta

ble

Belo

w

Av

er-

age

Av

era

ge

Very G

oo

d

Excelle

nt

Chief Complaint stated (with indication of duration if appropriate) 0 2 3 4 5 N/A HPI addresses onset, intensity, duration, alleviating/exacerbating factors, etc. 0 2 3 4 5 N/A HPI chronology clear 0 2 3 4 5 N/A HPI contains appropriate ROS systems 0 2 3 4 5 N/A HPI free of extraneous information 0 2 3 4 5 N/A Childhood history described as appropriate

Pregnancy and delivery history included if appropriate 0 2 3 4 5 N/A

Adult history described as appropriate 0 2 3 4 5 N/A Medications described as appropriate. Student demonstrates knowledge of all of

patient’s medications, medication classes, and potential side effects. Recognizes

potential for interactions as appropriate. 0 2 3 4 5 N/A

Social history described as appropriate. Should generally include:

Alcohol

Tobacco

Drugs

0 2 3 4 5 N/A

Family history described as appropriate 0 2 3 4 5 N/A Adult history described as appropriate 0 2 3 4 5 N/A ROS described as appropriate. Systems well-selected. Pertinent positives and neg-

atives addressed. If not previously addressed, should generally include:

Pulmonary

Cardiac

Abdomen

0 2 3 4 5 N/A

ROS positive findings appropriately addressed. ROS description avoids extraneous systems. 0 2 3 4 5 N/A Physical Examination described as appropriate. Should always include:

General appearance

Vital Signs

Pulmonary

Cardiac

Abdomen

0 2 3 4 5 N/A

Physical examination description avoids extraneous systems. 0 2 3 4 5 N/A

154

Diagnostic Studies Describes diagnostic studies performed 0 2 3 4 5 N/A Provides rationale for studies selected 0 2 3 4 5 N/A Discusses contraindications and limitations of studies 0 2 3 4 5 N/A Accurately interprets findings of studies, recognizing ambiguous results 0 2 3 4 5 N/A Suggests additional diagnostic studies as appropriate 0 2 3 4 5 N/A

Assessment Student demonstrates ability to develop logical differential diagnosis based upon

the history, physical examination, and diagnostic studies. 0 2 3 4 5 N/A

Student demonstrates awareness of any chronic conditions in need of maintenance 0 2 3 4 5 N/A Student recognizes issues related to prevention (smoking, obesity, etc.) 0 2 3 4 5 N/A

Plan Plan follows logically from assessment; addresses all issues 0 2 3 4 5 N/A Plan is practical, consistent with patient’s education level, socioeconomic status,

and support system 0 2 3 4 5 N/A

Presentation Presentation organized; flowed logically 0 2 3 4 5 N/A Responded appropriately to questions 0 2 3 4 5 N/A Presented without prompting

Score: □ Pass □ Fail - score <2.0

□ Fail - critical omission(s):

Comments:

_____________________________________ ____________________________________ Evaluator #1 Evaluator #2

155

APPENDIX P

Competencies

Student Name:_________________________________________________ Date:

The following competencies were developed by the American Academy of Physician Assistants,

the Physician Assistant Education Association, the Accreditation Review Commission on Educa-

tion for Physician Assistants, and the National Commission on Certification of Physician Assis-

tants.

Physician Assistant Competencies: A Self-Evaluation Tool Rate your strength in each of the competencies using the following scale: 1 = Needs Improvement 2 = Adequate 3 = Strong 4 = Very Strong

MEDICAL KNOWLEDGE

Medical knowledge includes an understanding of pathophysiology, patient presentation, differential diag-

nosis, patient management, surgical principles, health promotion, and disease prevention. Physician assis-

tants must demonstrate core knowledge about established and evolving biomedical and clinical sciences

and the application of this knowledge to patient care in their area of practice. In addition, physician assis-

tants are expected to demonstrate an investigatory and analytic thinking approach to clinical situations.

Physician assistants are expected to:

understand etiologies, risk factors, underlying pathologic process, and epidemiol-

ogy for medical conditions 4 3 2 1

identify signs and symptoms of medical conditions 4 3 2 1 select and interpret appropriate diagnostic or laboratory studies 4 3 2 1 manage general medical and surgical conditions to include understanding the in-

dications, contraindications, side effects, interactions, and adverse reactions of

pharmacologic agents and other relevant treatment modalities 4 3 2 1

identify the appropriate site of care for presenting conditions, including identify-

ing emergent cases and those requiring referral or admission 4 3 2 1

identify appropriate interventions for the prevention of pathophysiologic

conditions 4 3 2 1

identify the appropriate methods to detect pathophysiologic conditions in an

asymptomatic individual 4 3 2 1

differentiate between the normal and the abnormal in anatomic, physiological,

laboratory findings, and other diagnostic data 4 3 2 1

appropriately use history and physical findings and diagnostic studies to formulate

a differential diagnosis 4 3 2 1

provide appropriate care to patients with chronic pathophysiologic conditions 4 3 2 1

156

INTERPERSONAL & COMMUNICATION SKILLS

Interpersonal and communication skills encompass verbal, nonverbal and written exchange of infor-

mation. Physician assistants must demonstrate interpersonal and communication skills that result in effec-

tive information exchange with patients, their patients’ families, physicians, professional associates, and

the health care system. Physician assistants are expected to:

create and sustain a therapeutic and ethically sound relationship with patients 4 3 2 1 use effective listening, nonverbal, explanatory, questioning, and writing skills to

elicit and provide information 4 3 2 1

appropriately adapt communication style and messages to the context of the indi-

vidual patient interaction 4 3 2 1

work effectively with physicians and other health care professionals as a member

or leader of a health care team or other professional group 4 3 2 1

apply an understanding of human behavior 4 3 2 1 demonstrate emotional resilience and stability, adaptability, flexibility, and toler-

ance of ambiguity and anxiety 4 3 2 1

accurately and adequately document and record information regarding the care

process for medical, legal, quality, and financial purposes 4 3 2 1

PATIENT CARE

Patient care includes age-appropriate assessment, evaluation, and management. Physician assistants must

demonstrate care that is effective, patient-centered, timely, efficient, and equitable for the treatment of

health problems and the promotion of wellness. Physician assistants are expected to:

work effectively with physicians and other health care professionals to provide

patient-centered care 4 3 2 1

demonstrate caring and respectful behaviors when interacting with patients and

their families 4 3 2 1

gather essential and accurate information about their patients 4 3 2 1 make informed decisions about diagnostic and therapeutic interventions based on

patient information and preferences, up-to-date scientific evidence, and clinical

judgment 4 3 2 1

develop and carry out patient management plans 4 3 2 1 counsel and educate patients and their families 4 3 2 1 competently perform medical and surgical procedures considered essential in the

area of practice 4 3 2 1

provide health care services and education aimed at preventing health problems or

maintaining health 4 3 2 1

PROFESSIONALISM

Professionalism is the expression of positive values and ideals as care is delivered. Foremost, it involves

prioritizing the interests of those being served above one’s own. Physician assistants must know their pro-

fessional and personal limitations. Professionalism also requires that PAs practice without impairment

from substance abuse, cognitive deficiency, or mental illness. Physician assistants must demonstrate a

157

high level of responsibility, ethical practice, sensitivity to a diverse patient population, and adherence to

legal and regulatory requirements. Physician assistants are expected to demonstrate:

understanding of legal and regulatory requirements, as well as the appropriate role

of the physician assistant 4 3 2 1

professional relationships with physician supervisors and other health care pro-

viders 4 3 2 1

respect, compassion, and integrity 4 3 2 1 responsiveness to the needs of patients and society 4 3 2 1 develop and carry out patient management plans 4 3 2 1 accountability to patients, society, and the profession 4 3 2 1 commitment to excellence and on-going professional development 4 3 2 1 commitment to ethical principles pertaining to provision or withholding of clinical

care, confidentiality of patient information, informed consent, and business prac-

tices 4 3 2 1

sensitivity and responsiveness to patients’ culture, age, gender, and disabilities 4 3 2 1 self-reflection, critical curiosity, and initiative 4 3 2 1

PRACTICE-BASED LEARNING AND IMPROVEMENT

Practice-based learning and improvement includes the processes through which clinicians engage in criti-

cal analysis of their own practice experience, medical literature, and other information resources for the

purpose of self-improvement. Physician assistants must be able to assess, evaluate, and improve their pa-

tient care practices. Physician assistants are expected to:

analyze practice experience and perform practice-based improvement activities

using a systematic methodology in concert with other members of the health care

delivery team 4 3 2 1

locate, appraise, and integrate evidence from scientific studies related to their pa-

tients’ health problems 4 3 2 1

obtain and apply information about their own population of patients and the larger

population from which their patients are drawn 4 3 2 1

apply knowledge of study designs and statistical methods to the appraisal of clini-

cal studies and other information on diagnostic and therapeutic effectiveness 4 3 2 1

apply information technology to manage information, access on-line medical in-

formation, and support their own education 4 3 2 1

facilitate the learning of students and/or other health care professionals 4 3 2 1 recognize and appropriately address gender, cultural, cognitive, emotional, and

other biases; gaps in medical knowledge; and physical limitations in themselves

and others 4 3 2 1

SYSTEMS-BASED PRACTICE

Systems-based practice encompasses the societal, organizational, and economic environments in which

health care is delivered. Physician assistants must demonstrate an awareness of, and responsiveness to,

the larger system of health care to provide patient care that is of optimal value. PAs should work to im-

prove the larger health care system of which their practices are a part. Physician assistants are expected

to:

158

use information technology to support patient care decisions and patient education 4 3 2 1 effectively interact with different types of medical practice and delivery systems 4 3 2 1 understand the funding sources and payment systems that provide coverage for

patient care 4 3 2 1

practice cost-effective health care and resource allocation that does not compro-

mise quality of care 4 3 2 1

advocate for quality patient care and assist patients in dealing with system com-

plexities 4 3 2 1

partner with supervising physicians, health care managers, and other health care

providers to assess, coordinate, and improve the delivery of health care and pa-

tient outcomes 4 3 2 1

accept responsibility for promoting a safe environment for patient care and recog-

nizing and correcting systems-based factors that negatively impact patient care 4 3 2 1

apply medical information and clinical data systems to provide more effective,

efficient patient care 4 3 2 1

use the systems responsible for the appropriate payment of services 4 3 2 1

159

APPENDIX Q

Summative Professionalism

Assessment Tool

Assessment Category

Alw

ays

Usu

ally

Occ

asio

nal

ly

Sel

do

m

No

t A

pp

li-

cab

le

General Did the student exhibit a positive and profession attitude?

4 3 2 1 N/A

Did the student exhibit emotional stability, maturity, empathy, and physi-

cal and mental stamina? 4 3 2 1 N/A

Did the student maintain current immunizations, CPR, and background

checks? 4 3 2 1 N/A

Did the student act appropriately in stressful situations? 4 3 2 1 N/A

Did the student report any physical handicap or health issues that may

affect their ability to provide safe, effective medical care? 4 3 2 1 N/A

Professional

Did the student show respect for other students and faculty members? 4 3 2 1 N/A

Did the student comply with dress codes on campus and/or clinical sites? 4 3 2 1 N/A

Was the student on time for classes and clinical rotations? 4 3 2 1 N/A

Did the student exhibit unprofessional behaviors (including unnecessary

conversation in class during lectures or laboratory sessions? 4 3 2 1 N/A

Was the student able to work cooperatively, promoting and preserving

relationships with peers and other members of the healthcare team? 4 3 2 1 N/A

Academic

Did the student demonstrate the ability to learn and function in a

wide variety of didactic and clinical settings? This includes

demonstrating cognitive abilities necessary to master relevant con-

tent in basic science and clinical courses to provide the standard of

care.

4 3 2 1 N/A

Was there evidence that the student can communicate effectively,

both verbally and written, using appropriate grammar, spelling, and

vocabulary?

4 3 2 1 N/A

160

Did the student exhibit academic integrity? 4 3 2 1 N/A

Did the student demonstrate adaptability relative to changing situa-

tions, environments and new information? 4 3 2 1 N/A

Clinical

Did the student protect the patient’s safety and promote the pa-

tient’s well-being? 4 3 2 1 N/A

Did the student uphold ethical standards for health care? 4 3 2 1 N/A

Did the student provide competent medical care and extend to each

patient the full measure of professional ability as s dedicated, empa-

thetic student healthcare provider during clinical rotations?

4 3 2 1 N/A

Did the student provide competent medical care under the supervi-

sion of an assigned preceptor 4 3 2 1 N/A

Did the student demonstrate the ability to learn and function in a

wide variety of clinical settings? 4 3 2 1 N/A

Comments

Faculty Signature Date

Student Signature Date

161

APPENDIX R

Study Plan Contract

STUDENT PANCE PREPARATION STUDY CONTRACT

Student: ________________________________________

Date: _____________________

Faculty: _____________________________

Time Start: _____________End: ___________

Mode of Contact:

Student Initiated Faculty Initiated Other: _________________

Describe the reason for this encounter:

SUMM I SCORE_____

PACKRAT SCORE_____

SUMM II SCORE______

PREDICTED SCORE______

MR 1 SCORE BELOW 202____ 216____

MR II SCORE BELOW 498____ 513____

PACKRAT SCORE BELOW 128____ 138____

PREDICTED SCORE BELOW 369____ 458____

RISK STATUS

EXTREEM _____

SERIOUS ______

COMMENTS ABOUT SCORES AND PP

PANCE STUDY ACADEMIC REMEDIATION METHODS REVIEWED:

162

CLASSROOM TO CLERKSHIP COMP EXAM

%_____ %______ %______

%______ %______ %_______

Alternative Classroom to Clinic Study Method Question Construction

Reviewed Questions_____

COMPLETED TOPICS IN CLERKSHIP STUDY LIST

Make comments about quality of question construction

Pediatrics ____

Internal Medicine ____

Surgery_____

Emergency Medicine ____

Family Practice ____

Geriatrics ____

Orthopedics ___

OB-GYN _____

Psychiatry ______

ALTERNATIVE TEST BANKS RECOMMENDED

KAPLAN Q BANK ONLINE ___

NCCPA PRACTICE TESTS

1._____

163

COMMENTS/NOTES:

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

PLANS RECOMMENDED FOR STUDENT

COMPLETE ______COMP EXAMS IN CLASSROOM TO CLINIC

BY DATE________________

COMPLETE TWO NCCPA PRACTICE EXAMS

SIGN UP FOR KAPLAN Q BANK

FOLLOW UP EVERY _____WEEKS

COMPLETE TEST QUESTION STUDY PROGRAM

SEND ALL TEST SCORES BY EMAIL TO ADVISOR

FOLLOW-UP SUMMARIES

Date: ___________ Faculty:

TOPICS

KAPLAN CUMULATIVE PERFORMANCE

NCCPA PRACTICE EXAM SCORES

C TO C COMP EXAMS

STATUS OF QUESTION CONSTRUCTION

164

Date: ___________ Faculty:

TOPICS

KAPLAN CUMULATIVE PERFORMANCE

NCCPA PRACTICE EXAM SCORES

C TO C COMP EXAMS

STATUS OF QUESTION CONSTRUCTION

Date: ___________ Faculty:

TOPICS

KAPLAN CUMULATIVE PERFORMANCE

NCCPA PRACTICE EXAM SCORES

C TO C COMP EXAMS

STATUS OF QUESTION CONSTRUCTION

Terms: Student understands that failure to complete study plan will result in a

grade of I (Incomplete) in PA 632/633 and will delay graduation

Student Agreement to above study plan and terms __________________________

Faculty signature __________________________________

Course ___________________________________________